Care Home: Cooper House

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What the care home does well People living at Cooper House are supported by staff, many of which are experienced and have attained a qualification in care. Everyone has a comprehensive care plan which details the care and support each person requires, along with their views and expectations as to how they wish to be supported and cared for. We observed staff supporting people with sensitivity and respect, and with consideration to their privacy and dignity, people we spoke with were complimentary about the attitude and approach of staff and the care they received. Surveys we sent to people who live at Cooper House and their relatives asked them what they thought the home did well, and also asked them if their was anything else they would like to tell us. They wrote:`All aspects of care, appears to do well.` `It`s clean and tidy with a good standard of basic care.` `Care team are supportive, not just to my mum but all residents.` `The entertainment also the meals.` `Everything.` `Quite contended with treatment I am getting.` We sent surveys to health care professionals, and asked them what they thought the home did well, and whether they had any other comments. They wrote:`Keep up the good work.` `The staff are always willing to give me comprehensive feedback re the clients.` `The care they give to the residents is excellent. The resident always comes first and are shown respect and dignity at all times. The staff always seek advice if any health concerns arise, I feel honored to work with the staff at this home.` What has improved since the last inspection? People living at the home have a comprehensive care plan, which provides staff with clear guidance as to what is important to a person, and what care and support they require, and how they would like to be supported and cared for. Care plans include peoples wishes and expectations, their likes and dislikes, which enables staff to support people well. Staff have received training in safeguarding adults from abuse and moving and handling training, which means that the health and welfare of people is recognised and promoted. Care plans refer to risk assessments which identify potential risks, and record how the risk can be reduced, whilst not impacting on a persons right tomaintain their individuality and independence. People staying at Cooper House now have greater access to information, with information about the home and now to complain being kept in each persons bedroom. Meetings are now held with greater frequency, and the views of people are being sought as to the service they receive. What the care home could do better: Where people require support and care because they have dementia or suffer memory loss could be improved, by care plans containing greater information and guidance. Staff need to attend training which tells them how dementia affects a person, and how they as staff can support and minimise peoples anxiety. Environmental improvements to the standard of decor, and how the environment for people who have dementia could be altered to minimise anxiety and help people to orientate themselves within the home. This information should be recorded within their care plan. Systems need to be introduced to ensure that when people are asked their views and opinions as to the care and support they receive, this is acted upon. By ensuring that their views are centre to the philosophy of the home. Staffing levels to be continually reviewed to ensure that the wishes of people as detailed within their care plan is being delivered. The range of activities and trips out need to be increased. People have been asked in meetings about activities and trips, and their wishes have been included into their care plan, but little has taken place to achieve this. Surveys we sent to people who live at Cooper House and their relatives asked them what they thought the home could do to improve, and also asked them if their was anything else they would like to tell us. They wrote:`I cannot really see how the home can improve as I am really happy with everything at the moment.` `Better meals.` `Be less institutional. On the whole the home is run well, and the home is trying to work to a more person centred approach. I feel this is restricted at times because of staffing levels.` `More activities would be good.` `Maybe employ one or two extra staff and possibly staff could be employed to sit in main room to oversee the residents and also have a hobby therapist to stimulate the residents.` Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cooper House Pasley Road Eyres Monsell Estate Leicester LE2 9BT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Linda Clarke     Date: 1 2 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 32 Information about the care home Name of care home: Address: Cooper House Pasley Road Eyres Monsell Estate Leicester LE2 9BT 01162782341 01162782341 socis210@leicester.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Leicester City Council care home 29 Number of places (if applicable): Under 65 Over 65 20 20 29 5 10 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability sensory impairment Additional conditions: 0 0 0 0 0 Service User Numbers DE(E) & MD(E) No one falling within category DE(E) or MD(E) may be admitted into Cooper House when 20 persons who fall within categories/combined categories DE(E) or MD(E) are already accommodated within the home Service User Numbers PD(E) No one falling within category PD(E) may be admitted into Cooper House where there are 5 persons of category PD(E) already accommodated within the home Service User Numbers SI(E) No one falling within category SI(E) may be admitted into Cooper House where there are 10 persons of category SI(E) already accommodated within the home Date of last inspection Care Homes for Older People Page 4 of 32 Brief description of the care home Cooper House Residential Home provides accommodation for up to twenty-nine older people and is owned by Leicester City Council. The Home is situated in a residential area, close to shops, GP surgery and other local amenities. The Home is on the main road and on a bus route with the bus stop directly outside the Home. Car parking is available to the front of the Home. Cooper House is a large purpose built property. Accommodation is offered on the ground and first floor level, which can be accessed by a passenger lift. Bath/shower and toilet facilities are located throughout the Home. There is a garden to the front and a small patio to the side of the Home, close to the lounge and dining room. A conservatory with a patio overlooks the garden to the rear of the Home. All areas of the Home are accessible to people using mobility support, aids and equipment. Information is located on site detailing the range of services offered, which includes the Statement of Purpose and Service User Guide. Cooper House has copies of The Care Quality Commission, (CQC) Inspection Reports, and are available upon request. Information regarding fees is available by contacting the Manager of Cooper House. An individuals financial contribution to their care is dependent upon a financial assessment. There are additional individual expenditures such as hairdresser, chiropodist, newspapers, magazines and personal toiletries and the fee will depend on the services received. Care Homes for Older People Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We as it appears throughout the Inspection Report refers to The Care Quality Commission. The inspection process consisted of pre-planning the inspection, which included reviewing the Annual Quality Assurance Assessment (AQAA), which is a selfassessment tool completed by a representative of the service, reviewing previous Inspection Reports, and any information we have received. The unannounced site visit commenced on the 12th May 2009, and took place between 11:30 and 19:00 The focus of the inspection is based upon the outcomes for people who use the service. The method of inspection was case tracking. This involved identifying people with Care Homes for Older People Page 6 of 32 varying levels of care needs and looking at how these are being met by the staff at Cooper House. Five people were chosen and discussions were held with three of them, along with three other people who live at the home. Staff members were spoken with along with the Assistant Manager and Manager. We also sent surveys to some people who live at Cooper House, and their relatives. Surveys were also sent to health and social care professionals, and a selection of staff who work at the home, to seek their views about the home. What the care home does well: What has improved since the last inspection? People living at the home have a comprehensive care plan, which provides staff with clear guidance as to what is important to a person, and what care and support they require, and how they would like to be supported and cared for. Care plans include peoples wishes and expectations, their likes and dislikes, which enables staff to support people well. Staff have received training in safeguarding adults from abuse and moving and handling training, which means that the health and welfare of people is recognised and promoted. Care plans refer to risk assessments which identify potential risks, and record how the risk can be reduced, whilst not impacting on a persons right to Care Homes for Older People Page 8 of 32 maintain their individuality and independence. People staying at Cooper House now have greater access to information, with information about the home and now to complain being kept in each persons bedroom. Meetings are now held with greater frequency, and the views of people are being sought as to the service they receive. What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 9 of 32 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 10 of 32 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Cooper House enables people who require residential care to make an informed decision as to whether the home is appropriate to their needs by providing information about the services it provides and through its assessment and review process. Evidence: We wanted to look at the information provided to people who use the service to find out whether it was detailed and answered all their questions, and to find out how the service passed on the information. We spoke with people who live at Cooper House and looked at the information provided by the Manager in the self assessment tool, which was sent to us before the site visit. Information about Cooper House is detailed within a document called the Service User Guide, along with other information about the home and the services provided, a copy of the information is kept within each bedroom. We sent surveys to people who live at Care Homes for Older People Page 12 of 32 Evidence: Cooper House and their relatives, and surveys told us that people felt that they received enough information about the service which enabled them to decide whether Cooper House was the home for them. We spoke with three people who told us that they themselves had not visited Cooper House before moving in, but that a relative had visited on their behalf. We looked at the records of five people who live at Cooper House, and found that individuals had had their needs assessed by a Social Worker, before moving into the home, this enables the Manager to look at the information provided and decide whether their needs can be met by the staff and facilities at the home. After four weeks of living at Cooper House, a meeting is held involving the person who has moved into the home, their relatives, a Social Worker and someone who works at the home, to review the needs of the person, and to find out whether everyone is satisfied with the care and support being provided. A review is then held annually, unless their are significant changes in the persons needs, in which case they are held earlier, to ensure that the persons needs continue to be met by the home, and that the person is happy to continue living at the home. Care Homes for Older People Page 13 of 32 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs, choices and expectations of care, and the principles of respect, dignity and privacy are put into practice. Evidence: We wanted to find out how the health and personal care needs of people living at the home were met. We spoke with people living at the home and observed the care and support provided by staff, we also looked at the care plans and records of five people. The care plans that we looked at, started by providing information about a persons life before they moved into the home, including information as to their employment, family, hobbies and interests, this enables staff to understand whats important to the person, and how their experiences have influenced their choices and decisions. Care plans provide information about the care and support an individual requires, and how the person wants the care and support to be provided, such as what time someone wishes to get up, how many staff are needed to provide the support and whether any Care Homes for Older People Page 14 of 32 Evidence: equipment is required. Care plans also include preferences in relation to personal care, which included the type of deodorant or soap someone likes and the gender of the carer who will provide the care. Care plans also include information as to how a person chooses to spend their day, such as sitting in the conservatory, or staying in their own room to watch television. Information is supported by risk assessments, which are referred to within the care plan, risk assessments identify potential risks, and put measures into to place to reduce the risk further promoting the health and welfare of individuals. Care plans also provide information about a persons health care needs, including medication, and what measures staff need to take to monitor an individuals health. Care plans we looked at also included information about a persons wishes should they become ill, this is known as an end of life decision, information was also recorded if someone had identified instructions with regards to their funeral arrangements, including who should be contacted. We spent time with someone who lived at the home, and asked them about the care they receive and their experiences of moving into Cooper House. They told us that their spouse had visited on their behalf, and that when they moved into the home they were unhappy, but after a few days they settled in and are now happy at the home. They told us I think its a marvellous place, all the carers are very good, theyre wonderful. Im looked after well, Im spoilt. We spoke with some of the people whose records we had looked at, they expressed satisfaction with the care they received, we also spoke with them about their care plan, and the information they provided confirmed that care plans were accurate and up to date. We sent surveys to health care professionals, which included General Practitioners and a District Nurse, surveys asked them for their views about the care provided to people who live at Cooper House. Information they provided told us that they are happy with the care provided by the staff of the home, and indicated that the privacy and dignity of people is promoted. Surveys included additional comments:Excellent attitude of staff. Deeply caring and compassionate. High value placed on autonomy and respect. If staff have any concerns regarding the service user they will always seek advice. Very pleased with the staff best care I have known. Care Homes for Older People Page 15 of 32 Evidence: The care they give to the residents is excellent. The residents always come first and are shown respect and dignity at all times. The staff always seek advice if any health concerns arise, I feel honored to work with the staff at this home. We looked at the medication and medication records of some people, and found them to be in good order, we also looked at the records of two people who were prescribed a Controlled Drug, and found that the medication stored on the premises was consistent with the records. Care Homes for Older People Page 16 of 32 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Opportunities are available for people to engage in activities, but these are not far ranging and are dependent upon the availability of staff to provide them and their organisation. Cooper House provides a wholesome and varied diet. Evidence: We wanted to find out how people spend their day, and how the staff working at the home support people to make decisions and stay in contact with relatives and friends, we did this by observing people throughout the day, talking with people at the home and by looking at the care plans and the records of five people. The care plans we looked at included information about who is important in the lives of each person, such as relatives and friends, and how the home was to support people in maintaining contact through visits, telephone calls and correspondence, including arrangements for contacting relatives in emergencies. In addition care plans provided information about peoples hobbies and interests, some examples that we read were barge grips and trips to the garden centre, musical performances, playing bingo, conversing, playing games and arts and crafts. We noted that the opportunity for people to engage is these activities is dependent upon the availability of staff, and the Care Homes for Older People Page 17 of 32 Evidence: organising of excursions. Staff told us that they have little time to spend with people, as they are needed to provide personal care, staff we spoke with, and surveys which we sent to staff told us that they would like to spend more time with people conversing with them, taking them out and engaging them in activities. When we arrived at Cooper House we spent time in the main lounge whilst we looked at records, the television was on when we arrived, some people appeared to be watching it, everyone sat around the outside of the room, some conversing with others, others talking to people who had come to visit them, whilst some sat unoccupied. At lunchtime those that required support were taking through to the dining room, one lady remained in the lounge with the television on, but she chose to sleep in the chair. After lunch people returned to the lounge, where the television remained on, no discussion was had with anyone as to whether they wanted the television on, or what channel they wanted to watch. A Church Service was held in the main lounge in the afternoon, and those who wished to attend did so, people sang along to the hymns and joined in the prayers. One lady later told us that she was a Roman Catholic and that the Priest visited her, but she enjoyed singing along to the hymns, even though she chose not to sit in the lounge where the Church Service was held. People who live at the home had recently taken part in a meeting, where they were asked about activities, minutes identified that people had requested a variety of trips out, including barge grips and visits to a garden centre, we asked the Assistant Manager whether any trips had been organised, and they told us they had not. Its important that the views of people if asked are acted upon, so that people living at the home feel valued and listened to. We sent surveys to people who live at the home and their relatives, which asked them if they participate in activities organised by Cooper House, responses were mixed, however two wrote additional comments:Could do with more activities. I go out with my family, not many activities in the home. The Manager told us that it had been agreed that an Activities Organiser would be recruited to work two hours a day, to support people to engage in activities. One gentleman told us that he joined in the bingo, but preferred to spend time in his room and read, he told us that the mobile library visits and he chooses books, he also told us that he has a newspaper delivered daily during the week. Staff told us that most Care Homes for Older People Page 18 of 32 Evidence: days they take one or two people out to visit the local shops and park, we saw one lady being taken out when we visited, and when they returned they told us they had been to the shop. We sat and joined in the evening meal and sat with a group of people who live at Cooper House. The menu was displayed on a board in the dining room, and their were four choices available followed by a choice of four desserts which included fresh fruit. The dining experience was unhurried, and everyone we observed ate heartily, with many people having a second serving. We sent surveys to people and asked them whether they enjoyed the meals provided by the home, these told us that a majority of people are generally satisfied. One person wrote in their survey would love a roast potato occasionally!. Care plans include information about peoples likes and dislikes with regards to food, including individual dietary requirements, and whether staff are required to provide support. Care Homes for Older People Page 19 of 32 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Cooper House are able to express their concerns, and have access to a complaints procedure, and are cared for by staff who are aware of their role and responsibility in safeguarding people from abuse and neglect. Evidence: We wanted to find out how the staff at Cooper House promote the safety and welfare of people who live at the home, written information supplied by the Manager before our visit told us about the policies and procedures staff have to follow, to safeguard vulnerable people. We looked at the training records and found that staff within the last twelve months have attended training as to their role and responsibilities in ensuring people in their care are protected, and what action they should take if they are concerned. We spoke with staff, and they told us that if they had any concerns or someone told them about an incident they would report this to a Manager. Information in the self assessment tool completed by the Manager details their role and responsibility is managing situations where people allege abuse or neglect. The copy of the complaints procedure is given to people when they move into the home and is kept within each bedroom, the Manager within the information they provided us told us that their have been no concerns or complaints within the last twelve months, and none have been received by the Care Quality Commission or its predecessor the Commission for Social Care Inspection. Care Homes for Older People Page 20 of 32 Evidence: We spoke with people living at the home and they told us that if they were worried or unhappy about something they would talk to a relative or a Manager, surveys which we sent to people who live at the home and their relatives told us that a majority of people know how to make a complaint, and that concerns they have made have been responded to appropriately. An unannounced visit by an individual appointed by Social Services to visit homes unannounced recommended that how to complain is discussed at the next service user meeting, to make sure that everyone knows how to complain. Care Homes for Older People Page 21 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Cooper House provides adequate accommodation, improvements to the internal decor and maintenance of the garden, could improve the quality of life and experience for people who live at the home. Evidence: We had a tour of Cooper House, all communal areas of the home were reasonably decorated, however we noted in communal areas including corridors, that wall paper was torn and paint work was marked. Information provided by the Manager before our visit told us that the smokers lounge had been decorated, which included new flooring. We sent surveys to people who live at the home which asked them if the home was fresh and clean, all indicated generally satisfaction. One person in their survey wrote could you fix the aerial in the conservatory please the picture is shocking, I would like to make better use of the conservatory. Cooper House has not been decorated with consideration to people who have dementia, the use of colours and patterns, signs and objects relevant to people, need to be part of the home, to help people orientate themselves, maximising their independence and reducing anxiety. Bathing, shower and toilet facilities are located on the ground and first floor, with Care Homes for Older People Page 22 of 32 Evidence: showers and specialist equipment making bathing and shower facilities accessible to those with a physical disability who require support with personal care. Care plans include information as to whether someone prefers a bath or shower, and as to whether specialist equipment such as a hoist is required. The dining area leads into a courtyard, which has been partitioned from the main garden by trellising, this area provides an area to sit and has potted plants and flowers. Cooper House has a large garden which is not maximised to the benefit of people living at the home, as it is not accessible without assistance, and is not well maintained, and would benefit from a gardener, who could weed and prune, and plant flowers and shrubs of interest to people. Opportunities for activities could also be provided by people who visit a garden centre purchasing and choosing plants and shrubs, which are put into the garden. Care Homes for Older People Page 23 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Cooper House are supported by qualified staff in care, but they do not have training in specialist areas. Staffing levels maintain the personal care of people living at the home, but are not always sufficient to promote person centred care as the individual has recorded in their care plan. Evidence: We spoke with staff who work at the home and asked them about staffing levels, they told us that their are five staff on duty in the morning, and four in the afternoon along with a Manager. Staff felt that generally their were sufficient staff, but felt that they had little or no time to spend with people other than to deliver personal care. Our observations were that call bells were responded to in a reasonable period of time, surveys we sent to people who live at the home and their relatives indicated that they find staff are generally available when they need them, but one person included an additional comment, which suggests that staffing levels are not always sufficient. They wrote:Sometimes she feels the staff are too busy and dont have time to deal with some issues. Our observations were that staff were very busy, which left little time to spend with people, offering reassurance or engaging in conversation, with interaction being Care Homes for Older People Page 24 of 32 Evidence: limited to when someone needed personal care or moving to another room. We asked relatives and people who live at the home, what the home could do to improve, one person wrote: - maybe employ one or two extra staff and possibly staff could be employed to sit in main room to oversee the residents and also have a hobby therapist to stimulate the residents. Whilst care plans promote person centred care, in that the views, wishes and expectations of a persons needs are recorded, such as preferred times for getting up and going to bed, and the day and time individuals would prefer to have a shower or bath, this can only be promoted by adequate staffing levels. We read the minutes of a recent care staff meeting, which contradicted the idea of person centred care, by advising staff about the times they should be offering baths and showers. Care plans also provide information as to hobbies and interests, and supporting people in achieving these is dependent upon staff availability and the organising of outings. We wanted to find out how staff were recruited and whether the recruitment of staff promotes the health and well being of people who use the service. The recruitment of staff at Cooper House is managed by the Human Resources Department of Leicester City Council, where records are kept, we therefore could not view these. Information supplied by the Manager within the self assessment tool, and surveys which we sent to staff told us that staff are recruited following a robust procedure, which includes seeking the two written references and the obtaining of a Criminal Record Bureau (CRB) disclosure. Information provided to us by the Manager before our site visit states that 81 of staff have obtained a National Vocational Qualification (NVQ) in Care. We looked at the training records of staff, and found that staff receive training related to their role in ensuring and promoting the health, safety and welfare of people living at the home, which includes, food hygiene, moving and handling, infection control and safeguarding adults from abuse. Staff have the opportunity to study through North Warwickshire and Hinckley College on a range of distance learning course, topics include the management and safe handling of medication, principles of care and dementia awareness. Training records identified that few staff have received training in dementia awareness, which should be given priority given that the home is registered to care for and support people who have dementia. For people to be supported and cared for well, which includes stimulation as well as personal care, staff need to access relevant training, and care plans need to be further developed to include a wider range of information about how a person requires support with reference to their dementia, confusion and memory loss. Care Homes for Older People Page 25 of 32 Care Homes for Older People Page 26 of 32 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Cooper House has been managed well and improvements have been made which have improved the care and support people who live at the home receive. Evidence: Cooper House has had a temporary Manager for twelve months, who has very recently returned to their original post of Assistant Manager at the home. Cooper House now has a new Manager, who had worked at the home for two days when we visited, and who has previous managerial experience working at another home. The Manager told us that that have a National Vocational Qualification at level 3 and are currently working towards level 4. The Manager and Assistant Manager both took part in the site visit as part of the Inspection. At the previous site visit when we undertook an Inspection we identified several areas for improvement, a majority of these have been acted upon, and we found that their have been improvements within Cooper House which has improved Care Homes for Older People Page 27 of 32 Evidence: the care and support people who live at the home receive. Care plans have improved and now contain the wishes, views and expectations of people with regards to their care, and risk assessments reflect all aspects of a persons care, both providing relevant information for staff as to how they should care and support people, whilst promoting safety. Staff have received training in moving and handling, and safeguarding adults from abuse, which further promotes the safety and welfare of people living at the home, our observations confirmed that staff now move and handle people appropriately. Through observation we found that staff were polite and courteous to people, and that their privacy and dignity were respected, people were addressed by their preferred name, which we noted on our last visit was not always the case. Our visit also noted that people living at the home have greater access to information, with information about the home and how to make a complaint being located in each bedroom. Cooper House has recently distributed questionnaires to people who live at the home and asked them for their views about the care they receive, the Manager advised us that these would be collated and analyzed. We advised the Manager that once this has happened, that people who live at the home and others who took part are provided with feedback as to the outcome of the quality assurance process, and what the home plans to do as a result of the surveys to improve things for people. Cooper House also reviews the quality of the care it provides by receiving visits from a person external to the home, who visits every month and speaks with people who live at the home, visitors and staff. They also look at records to find out whether the home is operating as expected by the organisation, they write a report as to their findings which includes recommendations and action points for the Manager. We looked at the last report and found that points we identified were also reflected within the report. These included reviewing how the views of people who live at the home are sought and acted upon, which included increasing the frequency of meetings with people living at the home and by ensuring that items discussed by people are then discussed in care staff meetings and actions are taken to address their views. Information provided by the Manager before our visit, and surveys we sent sent to staff along with staff we spoke with at the home, told us that staff attend regular meetings and have supervisions with their line manager, both events provide an opportunity for staff and managerial staff to express their views, identify training needs, and review work practices to improve the care and support they provide. The Manager prior to the site visit, submitted a self assessment tool (AQAA), which we Care Homes for Older People Page 28 of 32 Evidence: looked at before visiting the home. We found that it had been completed well, and included all the information we required, including ways in which the service could continue to improve. The documents included details as to the regular maintenance of equipment and systems in the home, including heating and electrical systems along with fire fighting equipment and systems. Care Homes for Older People Page 29 of 32 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 30 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 12 The Activity Organiser when recruited receives training and information about the range of activities and equipment available to support people with individual needs, such as dementia, physical disability and sensory impairment engage in worthwhile activities and recreational pursuits. Information should be sought from organisations and specialists who can provide guidance and information as to how the environment could be decorated and adapted to support people who have dementia. The garden is maintained and is attractive and accessible to people who wish to spend time outside or look at the garden. The standard of decor in the home is reviewed, and an action plan put into place to address shortfalls in the standard of decor and accommodation currently provided. A system is developed which ensures that when the views of people living at Cooper House are ascertained, they are acted upon, and feedback is provided which enables people at the home to know what action will be taken so that they can be confident that their views have been listened to. 2 19 3 19 4 19 5 32 Care Homes for Older People Page 31 of 32 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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