Inspection on 07/06/05 for Coppice Nursing Home

This inspection was carried out on 7th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Coppice Nursing Home 16/01/07

Coppice Nursing Home 01/11/05

Coppice Nursing Home 13/10/04

Coppice Nursing Home 17/04/04

Coppice Nursing Home 26/11/03

Coppice Nursing Home 24/06/03

Coppice Nursing Home 16/10/02

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

CARE HOMES FOR OLDER PEOPLE Coppice Nursing Home 84 Windsor Road Oldham Lancashire OL8 1RQ Lead Inspector Fiona Bryan Unannounced 7 June 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 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. Coppice Nursing Home F54-F04 s25431 Coppice NH v227705 070605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Coppice Nursing Home Address 84 Windsor Road, Oldham, Lancashire OL8 1RQ 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) 0161 626 8522 Riseway Care Homes Limited, Mainiland House, 12 Court Parade, East Lane, Wembley, Middlesex HA0 3HU Mrs Kathleen Knox Care Home with Nursing 43 Category(ies) of PD(E) Physical Dis - over 65 - 24 registration, with number OP Old age - 19 of places DE Dementia - 4 SI Sensory Impairment - 1 PD Physical Disability - 24 DE(E) Dementia - over 65 -15 Coppice Nursing Home F54-F04 s25431 Coppice NH v227705 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: No service user under 55 years to be admitted to the home. No more than 25 service users to be admitted for nursing care. One registered general nurse to be on duty 24 hours a day. The home manager shall be a first level registered nurse and be supernumerary for a minimum of 35 hours a week. Date of last inspection 13th October 2004 Brief Description of the Service: The Coppice is a large detached home set within a walled garden, which has been extended and extensively modernised to provide nursing care and personal care for up to 43 service users. The home is owned by Riseway Care Homes Limited, which is a privately owned company. The Coppice is under the day-to-day control of a general manager who is also a qualified nurse. Accommodation is provided over two floors. Thirty-nine of the rooms are single en-suite whilst two bedrooms and one double room without en-suite facilities are provided with hand washbasins. Two bathrooms and a shower room are provided on the ground floor and a further two bathrooms are provided on the first floor. One dining room is situated on each floor. The first floor has one lounge area whilst the ground floor has one large lounge incorporating a bar area and two further small lounges. The home is located close to the town centre and is accessible to local transport services. There is ample car parking space for those travelling to the home by car. Coppice Nursing Home F54-F04 s25431 Coppice NH v227705 070605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken by one inspector who spent a total of 9.75 hours at the home. Time was spent talking to residents and staff. Four residents were looked at in detail, looking at their experience of the home from their admission to the present day. Staff duty rotas and records of care were examined. Since the last inspection two qualified nursing staff have left the home and new staff are in the process of learning the home’s procedures. What the service does well: What has improved since the last inspection? Very few issues were identified at the last inspection that needed addressing, and the manager and staff have worked consistently to ensure that the home moves forward and continues to improve its service. Staff felt that staffing levels had improved, following a recommendation that numbers on night duty were reviewed due to the dependency of residents. This was done and staffing levels increased to reflect the care residents needed. Coppice Nursing Home F54-F04 s25431 Coppice NH v227705 070605 Stage 4.doc Version 1.30 Page 6 Records of wound care have improved and wounds are now photographed with the permission of the resident, to help staff monitor how well a wound is healing. Steps have been taken to improve the food provided and new menus are under review. 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. Coppice Nursing Home F54-F04 s25431 Coppice NH v227705 070605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Coppice Nursing Home F54-F04 s25431 Coppice NH v227705 070605 Stage 4.doc Version 1.30 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 standard(s) 3 and 4 Residents’ needs are not always fully assessed before they come into the home. Staff have training opportunities provided to ensure that they can attain the skills and knowledge to meet the needs of the residents. EVIDENCE: The care files for three residents were looked at in detail. Two files had full assessments covering all aspects of the residents’ personal, healthcare and social needs. One resident who had been admitted to the home nine days before the inspection did not have all the information required, particularly risk assessments for nutrition and pressure sores. Staff were able to describe the needs of the residents well and said that they found out what the needs of new residents were by reading the pre-admission assessment, receiving a verbal report from the nurse in charge and by talking to the resident and their family. Life histories were available which help the staff to view residents as individuals with their own story to tell. A number of staff had received training in dementia care and it is planned that all staff will undertake this training as a rolling programme. Staff said how Coppice Nursing Home F54-F04 s25431 Coppice NH v227705 070605 Stage 4.doc Version 1.30 Page 9 much they had enjoyed the training and were able to give examples of how their practice had changed as a result, due to their increased knowledge and understanding in how to care for this group of residents. Coppice Nursing Home F54-F04 s25431 Coppice NH v227705 070605 Stage 4.doc Version 1.30 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 standard(s) 7,8 and 10 Residents’ needs are set out in individual care plans but more rigour is needed in the risk assessment and reviewing process. Actions required in the care plan must be carried out to ensure that health care needs are always met. Residents feel that they are treated with dignity and respect. EVIDENCE: Since the last inspection two qualified members of staff have left employment at the home and new staff are being inducted into the correct way to document the care given to residents. The manager felt that this was the reason why not all the care plans had been reviewed monthly. The record of residents’ weights was not available on some files since January 2005. In addition to this the nutritional risk assessment for one resident whose condition had changed, had not been reviewed since January 2005, although there was evidence that staff had in practice taken steps to manage the resident’s condition by contacting the GP. Risk assessments for pressure sores had also not been reviewed in some cases since January 2005 and a waterlow score had not been calculated for one resident who had been admitted to the home nine days previously. Coppice Nursing Home F54-F04 s25431 Coppice NH v227705 070605 Stage 4.doc Version 1.30 Page 11 The record for residents’ manual handling assessments did not provide space to record when the assessment was reviewed, therefore it was not clear if the information was up to date. Some care plans were vague, for example stating to “encourage good fluid intake” without specifying what amount would constitute this. Care plans should be as specific as possible so that staff are able to monitor and evaluate care delivered effectively. Records showed that residents had been seen by GP’s, opticians, audiologists, the tissue viability nurse and some had attended hospital for out patient appointments. The home has developed very good links with the tissue viability service and has a dedicated tissue viability link nurse and a continence link worker who attend training and meetings and ensure that information is cascaded to other staff. Therefore staff are aware of best practice and access specialist advice promptly if required. At time of inspection community nurses were visiting some residents and they stated that the home communicated well with them and staff were professional and cooperative. An improvement was seen from the last inspection in the records relating to wound care. Wound care assessments were detailed and wounds had been photographed to help monitor progress. Care files need updating as it is still recorded that some residents have staff that no longer work at the home as key workers and team leaders. Residents were very complimentary about the attitude of staff and said that they were treated well, with courtesy and respect. Coppice Nursing Home F54-F04 s25431 Coppice NH v227705 070605 Stage 4.doc Version 1.30 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 standard(s) 12,13,14 and 15 The lifestyle needs of the residents are met. Visitors are encouraged and welcomed in to the home. Residents have some choice about their daily routine. Meals are served in a pleasant environment and are appetising and wholesome. EVIDENCE: The home has an activities organiser and residents said that they are asked what they would like to do each day. Activities include playing dominoes and other board games, watching videos and joining in sing-a-longs. When the weather is good residents said they enjoyed going in the garden. A Caribbean evening had been planned and one resident was busy making garlands for everyone to wear. Each resident has a care plan to address their social care needs. Updating the key worker system would help to ensure that residents that do not wish to join in group events have other opportunities to pursue leisure and recreational interests of their choice. Residents said that they were able to receive visitors at any reasonable time and that their families and friends were made welcome at the home. Residents sometimes felt that they had to adapt their preferred daily routine to “fit in” with the organisation and running of the home. However, residents said that if they wanted to have a lie in or stay up late watching television there was no pressure put on them to do otherwise. Coppice Nursing Home F54-F04 s25431 Coppice NH v227705 070605 Stage 4.doc Version 1.30 Page 13 Comments regarding the food provided were variable. Since the last inspection a new chef has commenced employment at the home and the menus have just been changed. The manager said these will be reviewed in a few weeks time. Lunch was served in two sittings – the first sitting was for residents who needed help to eat. The dining rooms were pleasant, with tables nicely set with tablecloths, flowers, milk and sugar. Music was playing quietly. The meal served for lunch was chicken korma and rice with peas and sweetcorn. A sample of the meal proved to be tasty, hot and appetising. Residents appeared to enjoy it. The manager said that staff take the menu round for the following day and residents are asked what they would like. Coppice Nursing Home F54-F04 s25431 Coppice NH v227705 070605 Stage 4.doc Version 1.30 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 standard(s) 16 and 18 Residents are confident that any complaints will be listened to and acted upon. The home’s policies, procedures and planned training protect residents from abuse. EVIDENCE: Residents said they would make any complaints to the manager and they felt they would be addressed properly. The complaints procedure is displayed in the reception area of the home. All new staff receive basic training in abuse awareness and whistle blowing and are referred to the local adult protection policies, which they are advised to read. Manager stated that when training in dementia care has been completed for all staff a programme has been sourced in respect of prevention of abuse and training will start for all staff on this topic. Staff stated that they would report any suspected abuse to the manager or the nurse in charge. Coppice Nursing Home F54-F04 s25431 Coppice NH v227705 070605 Stage 4.doc Version 1.30 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 standard(s) 19 and 26 The home is well maintained and safe for residents to use. The home is clean and pleasant to live in. EVIDENCE: At the time of the inspection the home was clean, tidy and comfortable. Residents were satisfied with the standard of cleanliness in the home and said that their rooms were cleaned daily. The manager stated that rooms were redecorated and refurbished as needed. One room had recently had the carpet replaced. It is planned to replace the lounge carpets on the ground floor in the near future. Coppice Nursing Home F54-F04 s25431 Coppice NH v227705 070605 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 There are sufficient numbers of staff and suitable skill mix to meet the needs of the residents. Staff are trained and competent. EVIDENCE: The majority of staff and residents felt that there were usually enough staff on duty to meet the residents’ needs. The manager is mindful of the dependency of the residents and will revise staffing levels accordingly if she feels there is a risk to the health and safety of residents. Staff said that staffing levels had improved since the last inspection. Agency staff are sometimes used but the majority of shifts are undertaken by the home’s permanent staff. Staff have more confidence in caring for people with dementia as a result of training they have received. Other training has taken place relevant to staff’s roles and responsibilities, for example the deputy manager has undertaken training in wound care and leg ulcers as she is the link nurse for tissue viability. The home has gained accreditation to enable it to provide adaptation courses for qualified nurses from overseas. Some staff were due to receive updates in mandatory training in health and safety topics. Coppice Nursing Home F54-F04 s25431 Coppice NH v227705 070605 Stage 4.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 Residents’ opinions are taken into account when organising the management and running of the home. EVIDENCE: Staff said formal staff meetings are held on an ad hoc basis when it is felt that there are a number of issues that need to be discussed. A handover at each shift also provides staff with an opportunity to discuss matters related to the care of the residents and the routine of the home. Residents’ meetings had been held in March and April 2005. Minutes of the meetings were displayed in the reception area. The manager said that the home had started working towards Investors In People and it was planned to introduce new quality assurance procedures that would be more useful to the home and that they would be better able to use to improve the service. Coppice Nursing Home F54-F04 s25431 Coppice NH v227705 070605 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x x x x x Coppice Nursing Home F54-F04 s25431 Coppice NH v227705 070605 Stage 4.doc Version 1.30 Page 19 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 3,7 Regulation 15 Requirement The registered person must ensure that relevant risk assessments are undertaken for residents and where risk is identified actions are put in place to reduce or eliminate the risk. The registered person must ensure that the residents care plans are reviewed at least once a month and updated and current objectives for health and personal care and actioned. The registered person must ensure that a record is maintained of residents weight. Timescale for action 31/7/05 2. 7 15 31/7/05 3. 8 14 31/7/05 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. 2. Refer to Standard 7 7 Good Practice Recommendations The registered person should ensure that care plans are detailed and provide specific information to enable staff to effectively monitor and evaluate care delivered. The registered person should ensure that care files are updated with the correct name of the residents key workers and team leaders. F54-F04 s25431 Coppice NH v227705 070605 Stage 4.doc Version 1.30 Page 20 Coppice Nursing Home Coppice Nursing Home F54-F04 s25431 Coppice NH v227705 070605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 2nd Floor, Heritage Wharf Portland Place Ashton-under-Lyne OL8 1RQ 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. 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