Inspection on 31/07/08 for The Koppers

This inspection was carried out on 31st July 2008.

CSCI found this care home to be providing an Good service.

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

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE The Koppers The Street Kilmington Axminster Devon EX13 7RJ Lead Inspector Vivien Stephens Unannounced Inspection 31st July 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 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. The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Koppers Address The Street Kilmington Axminster Devon EX13 7RJ 01297 32427 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) Mr Sadrudeen Baksh Mrs Vivian Guat Sim Baksh Mrs Vivian Guat Sim Baksh Care Home 24 Category(ies) of Dementia (24), Mental disorder, excluding registration, with number learning disability or dementia (24), Old age, of places not falling within any other category (24), Physical disability (24) The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia (Code MD) Old age, not falling within any other category (Code OP) Dementia (Code DE) Physical disability (Code PD) The maximum number of service users that can be accommodated is 24. 11th June 2007 2. Date of last inspection Brief Description of the Service: The Koppers is a detached, converted building in the village of Kilmington. The home provides accommodation with personal care for up to 24 older people who may also have a physical disability or a mental disorder; typically Alzheimer’s Disease or related health difficulties. It is able to cope with a degree of challenging behaviour in a secure environment. Bedroom accommodation for service users is on the ground and first floors, there are six single and nine double rooms. There is a stair lift to the first floor. There is a communal lounge and lounge/dining room on the ground floor and a new conservatory extension. There are pleasant gardens and two parking areas. The range of fees at the time of this inspection is from £450 to £600 per week. A copy of this inspection report will be made available by the home on request. The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. Since the last inspection the ownership of the home has changed. The home was previously owned by Starlight Care Ltd. Mr and Mrs Baksh were partners in this company, but earlier this year the ownership of the home was transferred to Mr and Mrs Baksh as a partnership. Mrs Baksh has continued to act as the registered manager of the home. Several weeks before this inspection took place we asked the home to complete an Annual Quality Assurance Assessment (AQAA). They completed the form and returned it to us by the date we requested. The form gave us some useful information about the home and the services provided. We sent out survey forms to find out people’s views about the home. We received 16 responses from people living in the home (some of these were completed by their families or friends), one letter from a relative, 5 responses from staff, 3 responses from GP’s and health professionals and one response from a care manager. The comments and views expressed in these surveys have helped us to form the judgements we have reached in this report. At the time of this inspection there were 20 people living in the home. Our visit began at 10am and finished at 6.20pm. During the day we talked to the owners, Mr and Mrs Baksh, the Acting Manager, and five people living in the home. We also talked to a relative who was visiting the home on the day. We carried out a tour of the home. We looked at some of the records the home is required to maintain, including assessments and care plans, daily reports, recruitment and training records, staff rotas, accident reports, menus, fire log book and records of money held by the home on behalf of people living there. What the service does well: During this inspection we met or heard from many people who praised the home. We received lots of positive comments, including one from a health professional who told us that The Koppers “Makes the patients feel cared-for The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 6 – they know the individuals’ little quirks and characters very well and have a good relationship/understanding of the patients and their families.” Good care is taken to make sure that people are fully assessed before any decision to move in is made. They will not let anyone move in unless they are certain they can meet the person’s needs. People are given information and opportunity to visit and get to know the home before deciding to move in permanently The home has an excellent care planning system in place that demonstrates they have a very good understanding of each person’s individual care needs, and the staff know exactly how each person wants to be assisted. The staff are well-trained and there is good co-operation with all health professionals to ensure people’s health and social care needs are fully met. Medicines are stored and administered safely. We heard many positive comments from friends and families about the home. We were told that they are encouraged to visit and participate in the home, and the home always keeps in touch with them if there are any problems or concerns. People are offered a good choice of menu that provides a balanced and healthy diet. If people have concerns with their care, they or people close to them, know how to complain. Their concerns will be looked into and action taken to put things right. The care home has good procedures to safeguard people from abuse, neglect or self-harm. There is a stable and happy staff team. Good recruitment procedures have been followed, and staff have received good induction and continuous training. A high ratio of staff hold a relevant qualification. The home is well managed. There are systems in place to make sure they continue make improvements and to get things right. If people want the home to look after their cash or valuables they can feel certain that it will be kept safe and accurately recorded. The owners and staff have been able to demonstrate that they take health and safety very seriously. The owners have sought specialist advice to make sure the environment is safe for people and staff. Staff have received training and updates on all relevant health and safety topics. The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: The home continues to have a large ratio of shared rooms. People have little choice about who they share a room with. People may not be given the opportunity to have a single room if they do not want to share. This means that people’s privacy, dignity and choice may be compromised. While many improvements have been made since the last inspection, more work on the home is still needed. There are still some areas, including toilets and bathrooms that look tired and worn. The home does not currently provide a warm, dry and safe place for those people who smoke. The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 8 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. The summary of this inspection report can be made available in other formats on request. The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 9 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 The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 6 Quality in this outcome area is good People can be confident the home will be able to support them. The admission process is personal and well-managed and people are given information and opportunity to get to know the home before deciding to move in permanently This judgement has been made using available evidence including a visit to this service. EVIDENCE: A recently updated copy of the statement of purpose/service users’ information pack was given to us during our visit. This document provides a range of information about the management, staff team and the services provided. It is given to people when they enquire about accommodation. We were told that everyone who is privately funded has been given a copy of the home’s contract. Those people who are publicly funded have received a contract from Social Services. The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 11 The home told us “When an enquiry is received we normally visit the person (wherever possible) to carry out a needs assessment and to provide information about The Koppers. We gather information from relatives/representative, health and social care professionals. We also invite people who are considering to move to The Koppers to visit the home, to stay for lunch or an afternoon to get to know the people and the environment in which they might live. They are given a brochure and a needs assessments is carried out, prior to admission,and detailed care plans drawn up. We confirm in writing to the prospective resident and their relatives that the home is suitable in meeting their needs before the admission is progressed. We fully involve the resident and their relatives in drawing up their care plan prior to admission.” During this inspection we looked at the files of four people living at the home. We found that the home had carried out a detailed assessment of their needs before they moved in, covering their social, personal and health care needs. (The home does not provide intermediate care.) The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11 Quality in this outcome area is good. People can be confident that the staff know exactly how they want to be assisted. The staff are well-trained and there is excellent cooperation with all health professionals to ensure people receive a very good standard of care. People’s privacy and dignity may be compromised by the practice of admitting people into a shared bedroom with someone they do not know. Medicines are stored and administered safely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at the care plans for four people living at the home and we also looked at other records completed by the home about these four people, The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 13 including medicines administered, accidents reports and risk assessments. We talked to these people to find out if the information in the care plans was correct. We found that the care plans have been written in a clear and straightforward manner. They are easy to read and covered all aspects of each person’s daily care needs. The plans explained what the person can do for themselves, and what they need help from the staff team. The plans gave enough detail about each task so that the staff know exactly what to do, while at the same time the plans are concise enough for the staff to read quickly and understand clearly exactly what they have to do. We found there were many small details that showed the staff know and understand each person very well, and have tailored the care to suit each individual. For example, in one care plan it said, “She will say when she wants to go to bed”, and in another plan it said, “She likes to get up between 6 am and 8am.” All staff have signed a sheet in each care plan file to show that they have read the care plan. All of the care plans have been signed either by the person, or by their advocate, to show that they agree with what is written and that the plans are correct. We saw risk assessments in each care plan file that showed that the home had considered any possible risks and had put measures in place to minimise those risks where possible. For example, a risk assessment has been completed for each person to find out if they are at risk of pressure sores. We saw evidence to show that the home has liaised closely with relevant health and social care professionals where advice or treatment is needed, and any equipment necessary has been provided. We saw that people who are at risk of pressure sores have special mattresses and cushions and staff make sure these are in use at all times. All of the health and social care professionals who completed survey forms were positive about the care provided by the home. One GP told us that the home is “very skilled at managing dementia and are often very successful at reducing medication. Always very supportive to GP’s when visiting. Provide detailed info and practical assistance. I recently had quite a stressful situation to deal with and Toni was professional, calming and understanding.” Another GP told us “Standard of care appears high with appropriate calls to the doctor for health needs.” We saw records to show that the home has carried out regular tests and checks where people may be at risk of health problems such as urine infections or diabetes. People’s weight is checked and recorded regularly. The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 14 One person recently suffered an injury and the staff applied dressings to the wound and then contacted the District Nurses to inform them of the action they had taken. The District Nurses checked the wound and dressing when they next visited the home. There is a handover session between each shift to ensure all staff are told about any changes in care needs that have occurred since they were last on duty. Since the last inspection the level of training for all staff on specialist topics has improved. Training has been provided, or is planned for the near future on a range of dementia topics, continence, the Mental Capacity Act, dealing with challenging behaviour, and diabetes. We found good evidence to show that the home treats people with respect and in most cases privacy and dignity are respected. However, the high ratio of shared bedrooms continues to compromise this standard. People are routinely admitted into shared rooms even though they may not know the other occupant of the room and may not have specifically expressed a wish to share a room with that person. We looked at the way the home handles medicines. The home uses a monitored dosage system supplied by a local pharmacy. The medicines are stored securely in a locked medicines trolley that is kept in a locked cupboard. Records have been accurately maintained of all medicines received into the home, administered and returned to the pharmacy. The home has secure storage for any controlled drugs. There is also a lockable refrigerator for any medicines that must be kept cool. The temperatures for this fridge have not been checked and recorded regularly – this is recommended. At the last inspection we were concerned about the number of people who regularly received their medicines disguised in foods (this practice is known as covert administration.) During this inspection we were given firm reassurance that this practice has now ceased and that the staff always explain to people that they are about to be given their medicines. We heard about one exception and in this particular case the home has liaised closely with the person’s GP to find a method that is suitable and safe for that one individual. We talked to the Acting Manager about the care provided to people who may be close to death. We heard that the home works closely with local GP’s and District Nurses to make sure that people are given all the care they need at the end of their lives. Detailed recording systems are used to show the regular checks and care given. All of the people we talked to during our visit, and the people who responded to our surveys praised the staff and the care they provide. A letter from relatives of a person who recently died at the home told us The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 15 “The care and attention given to our late mother at the very end of her life was exemplary. Whenever I visited the Home there was a friendly, calm atmosphere and the staff’s expertise, and concern for the comfort of the residents, was obvious. Their sensitive and compassionate approach was much appreciated in particular during my mother’s last days – not only to herself but also to myself. It has been a great comfort to know that she was in such caring and sympathetic hands.” The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. People’s quality of daily life has improved in recent months and they are offered a range of activities to suit most interests. Friends and families are encouraged to visit and participate in the home. People are offered a good choice of menu that provides a balanced and healthy diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the level of activities provided in the home has increased. Some of the staff have had training on activities in care homes by an organisation that specialises in this subject (known as NAPPA). A member of staff has been employed who has specific responsibility for arranging and providing a range of activities to suit each person living in the home. The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 17 The care plans we looked at showed that the home has identified the things people want to do each day. We were given a four-week programme for the activities that usually are provided. We were told that the home does not stick rigidly to this programme and that if people want to do something else the staff are always flexible. The activities listed on the programme include outings, walks in the local area, indoor games including bingo, dominos, card, crossword, target and floor games, music, arts and crafts, and gentle exercises to music. On the day of this inspection we saw people helping to lay and clear away the dining tables at meal times, and helping with flower arranging. In the afternoon people took part in various floor games. People told us how much they have enjoyed the activities provided by the home. One relative who completed a survey form told us “As daughter of the service user I am aware that activities are arranged. I would like to see less meaningless television on and more music played – either relaxing background music, or some jolly sing-songs that the inmates can re-call from long ago.” (The television was not switched on during this inspection). The home told us they intend to display the weekly activities plan in the hallway so that people can see what will be happening for that week. The home also told us they want to increase the level of one-to-one activities. The home does not have a vehicle specifically for use by the people living in the home. If people want to go out they are usually taken in one of the owners or staff’s cars. One member of staff who completed a survey form said the home would benefit from a car or minibus that could be used to take people out. We met the new gardener and heard about how people are encouraged to walk or sit in the garden, and to help with gardening tasks if they wish. There are various seats and pleasant areas to sit and enjoy the gardens. One person is regularly taken to the Age Concern drop-in centre in Honiton. The home told us in the AQAA form “We have also befriended Local Age Concern to join their Time for Life programme for some residents at the home. Residents were allocated with mentor who will assist residents to further their interests and maintain a wider links with the local community ie attend activities at the local age concern day centres and various fund raising and outings”. We saw references in the care plans to each person’s religion and whether they actively follow their chosen religion. A relative who was visiting the home on the day of this inspection talked about how satisfied he was with the care provided at the home and the way the The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 18 home welcomes and involves him. Other relatives who completed a survey form or wrote to us also praised the way the home keeps them in touch. Comments included “ Vivian will always ring my mobile and constantly inform me of any problems and needs Mum might have. Every member of staff seems friendly and helpful.” “My mother seems to like the food. We were told when she moved in that the food was all home cooked and nutritious.” The home employs a cook. We looked at the menus and saw that people receive a varied and balanced diet with plenty of choices to suit their individual preferences and dietary needs. The dining room is attractively decorated and furnished (some additional new dining chairs have been ordered to match those purchased approximately a year ago.) We talked to a member of staff about how they ensure people with dementia receive the nutrition they need. People’s weight is monitored regularly. The home will offer foods that can be picked up and eaten easily (‘finger foods’) if people cannot sit still for long, or if they struggle to eat with cutlery. Staff were seen helping people to eat. The staff helped one person at a time, and the process was personal and unhurried. We heard that the menus have been discussed with people living in the home and their families and friends and any suggestions/comments are invited. The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. If people have concerns with their care, they or people close to them, know how to complain. Their concerns will be looked into and action taken to put things right. The care home has good procedures to safeguard people from abuse, neglect or self-harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection no complaints or concerns have been received by the Commission. We looked at a book held in the entrance hallway in which people have been encouraged to voice any complaints, concerns and compliments. We saw a number of compliments but no complaints. We talked to Vivian Baksh about providing alternative methods of encouraging people to voice any concerns or complaints in a confidential manner. She said she had been intending providing a complaints/suggestions box in the hallway in which people can put comments in a confidential manner. The home told us in their AQAA “We adopt a friendly, open-door policy that welcome residents and relatives and visitors to come and talk to us with The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 20 concerns and worries. We will endeavour to address/resolve their concerns and worries as swiftly as possible.” The complaints procedure is set out in the Statement of Purpose given to each person before they move in. There is a clearly worded complaints procedure displayed in the entrance hallway. New staff have received some training on the protection of vulnerable adults during their induction. We also saw evidence in workbooks of more ‘in depth’ training each member of staff has received on this subject. They also told us they plan to give staff more training in the coming months. The home has policies and procedures in place covering all aspects of abuse and protection. Vivian Baksh has a good understanding of the procedures that must be followed if abuse or harm is suspected or alleged. The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 26 Quality in this outcome area is adequate. Recent improvements to the home have resulted in a much brighter, cleaner and more comfortable environment, but the large ratio of shared rooms means that people’s privacy, dignity and choice may be compromised. The home does not currently provide a warm, dry and safe place for those people who smoke. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We carried out a tour of the home during this inspection. During the day a company were visiting to install a new stairlift. The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 22 A new conservatory/garden room has recently been built and it was waiting for final clearance from the fire authority and finishing touches before it could be used by the people living in the home. This new room provides lots of natural light and is a solid construction with slated roof. It will provide a very attractive and comfortable sitting/dining room. The home also has a further sitting room plus a large lounge/dining room. The entrance hallway also has a sitting area, table and piano and is a useful additional sitting area. All of the communal rooms were attractively decorated and comfortably furnished. The home employs a maintenance man, a gardener and a cleaner. Mrs Baksh told us that they have been looking for appropriate signs to help people with dementia find their way around the home safely. They also plan to find a safe way of discouraging people with poor mobility from walking up the stairs if they are at risk of falling. They were planning to address this once the new stairlift has been installed. At the last inspection we found that some people living in the home who regularly smoked had to go outside when they wanted a cigarette. We told the owners they must provide a warm, safe and dry place for people to smoke. A number of things have happened in the last year, including a change of ownership and the provision of a new conservatory/garden room. The owners told us they are hoping to provide a new facility in the grounds for those people who smoke and they were in the process of trying to arrange this. We looked in every bedroom. The home continues to have a high ratio of shared bedrooms – there are six single rooms and nine shared rooms. We were concerned that people continue to be admitted to the home into a shared bedroom with someone they do not know, and have not expressed a wish to share with. We talked to Vivian Baksh about their plans to reduce the number of shared rooms. She said that they have employed an architect to find various ways of either dividing double rooms to create two single rooms, and to look at the possibility of building an extension to create additional bedrooms. No timescales for this work have been confirmed. Since the last inspection many bedrooms have been improved by redecoration and the provision of new carpets and furnishings. The furniture in the bedrooms was in good order. Some new furniture has been provided in rooms where furniture had become outdated and worn. Attractive bedspreads have been purchased in the last year and these have improved the appearance of the bedrooms. The garden was neat and tidy with attractive flowerbeds, sitting areas, shrubs and borders. The gardener was busy creating a new sensory area on the day of this inspection. A large bowl of bright and attractive flowers were cut from the garden and residents helped the staff to arrange these in vases that were placed around the home. The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 23 All of the radiators have been covered throughout the home to reduce the risk of accidental burns. All areas of the home were found to be clean and tidy. There were no unpleasant odours. One relative who completed a survey form told us “The refurbishments have made a great improvement. It is much cleaner than it was a year ago.” The laundry has a commercial washing machine and dryer. There is a maintenance contract in place and the machines were in working order at the time of this inspection. All people we met during the inspection were neatly dressed in clean and attractive clothing. The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. People are supported by sufficient well-trained and experienced staff to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of this inspection there were 20 people living in the home. No one was seriously ill. On duty in the home were the owners; Mr and Mrs Baksh, the Acting Manager, a Senior Care Assistant, and 3 care assistants. Also, there was a cook, a gardener and a maintenance man on duty. We were given a copy of the staff rotas for August 2008. These showed that there are always sufficient staff on duty to meet peoples’ needs. There is an ‘on call’ system for senior care/management support during evenings/weekends. At night there are two waking staff on duty. We looked at the employment files of three staff recruited since the last inspection. These staff were recruited using an employment agency and have come from overseas. We saw copies of the required Home Office visas, references and criminal records checks. The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 25 All new staff undertake a comprehensive induction programme that is signed by the staff member and a senior member of staff to confirm the topic has been covered. The home has purchased a training pack from a specialist training company covering a range of topics. We saw evidence of the topics covered by each member of staff. We were told that at the time of this inspection 78 of the care staff have achieved a relevant nationally recognised qualification known as NVQ to at least level 2. Some staff also hold, or are in the process of gaining, NVQ’s to level 3 or 4. Four staff who have been recruited from overseas hold nursing qualifications gained in the home countries. In the last year staff have received a range of training both in-house, or by bringing in trainers from outside, or by attending external courses. Further courses are planned for the coming months. The subjects covered by the ‘inhouse’ training programme have included infection control, risk assessment, first aid, manual handling, medication management, safeguarding vulnerable adults, food hygiene, health and safety, fire safety awareness, coping with aggression, dementia, diet and nutrition, and mental health awareness. Other subjects covered have included the Mental Capacity Act, dealing with challenging behaviour, activities, and dementia. Further training on various subjects relating to the care of people with dementia are booked for the near future. The District Nurses are also offering to provide training on infection control, diabetes and continence in the next few weeks. All staff have received training and regular updates on manual handling and fire safety. Some staff have recently received 1st Aid training and there are sufficient staff training to provide first aid cover at all times. Two cooks have been enrolled on NVQ courses. The staff we spoke to during the inspection, and those who completed survey forms were positive about their work and told us they are always given good information, support and training. They told us their induction training was good and covered all of the information they needed. They also said there are always or usually sufficient staff on duty. They told us there is good communication and co-operation among the staff team. The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 26 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. The home is well managed. There are systems in place to make sure they continue make improvements and to get things right. If people want the home to look after their cash or valuables they can feel certain that it will be kept safe and accurately recorded. The environment is safe for people and staff because health and safety practices are carried out. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information supplied in the AQAA before this inspection included – The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 27 “Mr Baksh and Mrs Baksh, Registered Manager, are both qualified Psychiatric nurses who hold current registration. The acting manager has worked at The Koppers for the last 15 years. They both have owned and managed a successful residential home in Dorset for over 16 years, between them, they have devoted over 35 years of their nursing career in caring for the elderly.” The people we talked to during this inspection were happy with the way the home is being managed. People told us they recognised and appreciated The ownership of the home changed earlier this year from Starlight Care Ltd (Mr and Mrs Baksh were partners in this company) to Mr and Mrs Baksh as partnership. Mrs Baksh has continued to be the registered manager of the home. The home has a range of methods of checking the quality of the services provided and ensuring the standards are continuously improved. An annual questionnaire was in the process of being improved and this will be sent out in November. Staff meetings are held every 6 weeks. Relatives meetings are held every 2 months. A comments book is kept in the entrance hallway. Mrs Baksh said she encourages people to speak out and to offer comments or suggestions. The home has reduced the number of people they handle cash or monies for. In the last year they have introduced a new system where the home will pay for regular bills such as hairdressing or chiropody and will invoice the person or a relative/representative who is acting on their behalf. These are sent out every 2 months. Receipts are retained for all items purchased. The system has been discussed and agreed with relatives in a recent meeting. Where the person has no relatives who will act on their behalf money has been paid into a bank account in the person’s name. Mr Baksh is a named representative. We could see clear recording of all items purchased by the home on behalf of the person. We looked at the way the home handles bank accounts for people whose fees are paid by bank. The home had safe systems in place. All incomes and outgoings could be followed. We looked at the records of accidents and incidents. These have been recorded accurately. The Commission has been notified of all deaths and serious accidents. We looked at the fire logbook and found that all equipment has been tested and maintained regularly. Staff have received training and regular fire drills. Good systems are in place to ensure the staff and people living in the home are safe. Staff have received regular training and updates on all health and safety related topics and policies and procedures are in place. The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 28 On the day of this inspection a privately employed fire specialist was visiting the home to provide advice on fire safety in the home. The owners said they feel fire safety is a very important topic and they wanted specialist advice to ensure their risk assessments were correct, and to ensure they have taken every precaution necessary to minimise the risk of fire. The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 29 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 x x N/a HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 2 x x 2 x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 30 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 OP10 Regulation 12(3) and (4) Timescale for action You must be able to demonstrate 01/01/09 that the home has respected the privacy and dignity of people who occupy a shared bedroom. You must be able to show that people have chosen to share a room, and with whom. Residents who regularly smoke 01/10/08 must have access to a warm and safe place where they can smoke safely without adversely affecting non-smoking people who live in the home. Requirement 2 OP20 23(2)(h) 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 OP9 Good Practice Recommendations The temperature of the medicines refrigerator should be checked every day to ensure it is at the correct temperature, and the temperature should be recorded. DS0000071621.V366184.R01.S.doc Version 5.2 Page 31 The Koppers 2 OP19 The programme of upgrading and redecorating the home should continue. Furnishings and fittings that have become old and worn should be replaced. The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 The Koppers DS0000071621.V366184.R01.S.doc Version 5.2 Page 33 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!