Care Home: Coplands Nursing Home

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What the care home does well The care home is welcoming, and purpose built. The `expert by experience` reported that he had had a positive first impression of the home. A visitor spoke of the home having a nice `atmosphere`. Comments from relative/visitors feedback surveys included `There is always a calm atmosphere`, and the home has `a family atmosphere`, and `it is a marvellous home`. A unit in the home has been specifically decorated to ensure that the environment is attractive and meets the varied needs of people who have dementia. The care home has four activity coordinators who enable people using the service to have the opportunity to participate in a variety of `one to one` and/or group activities. The expert by experience spoke highly with regard to the role of the activity co-ordinators. Comments from feedback surveys from people using the service included `I am happy with the religious activities`, and activities are `numerous and in all the units`, and `I always enjoy taking part in everything`.People are supported and encouraged to visit the care home before deciding to live in it. Comments included `I saw the home brochure, and I liked it and without hesitation I decided to come to Coplands, and I am happy here`, and `I came to view the home, so I knew how nice it was and the staff are wonderful`, and `I am happy here`. Meals meet the various religious, ethnic and vegetarian needs of people using the service. Comments included `the meals are very good, and everybody enjoys them`, and `I always enjoy the meals`. Staff receive a significant amount of ongoing, varied and appropriate training to ensure that they have the skills to understand, and meet the varied and multiple needs of people using the service. Comments from people using the service include; `the care is always very good and the people (staff) are always very caring`, and the `staff are always extremely helpful and kind`, and `the staff always help and advise in everything`. The manager is experienced and keen to develop and improve the service. She completed the Annual Quality Assurance Assessment (AQAA) very comprehensively, including information about what the home does well and of the plans for developing and improving the service. What has improved since the last inspection? Annual Quality Assurance Assessment information and inspection informed us that previous inspection requirements from the key inspection July 2007 had been met by the service. Information about the service is available in CD format; to enable residents who have difficulty in reading, gain information about the service provided by the care home. Several areas of the care home have been redecorated and some carpets have been replaced. Resident`s care plans have been reviewed and improved. The manager closely monitors their quality. People using the service have been encouraged and supported to communicate their views of the service and to be involved in the running of the home. The home has a regular newsletter in which residents contribute articles. The number and variety of activities have continued to be developed and improved. The procedures for the management of resident`s monies have been reviewed and improved, to ensure that people using the service receive interest on their savings. CARE HOMES FOR OLDER PEOPLE Coplands Nursing Home 1 Copland Avenue Wembley Middx HA0 2EN Lead Inspector Judith Brindle Key Unannounced Inspection 8th and 9thJuly 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Coplands Nursing Home DS0000022924.V365946.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. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Coplands Nursing Home Address 1 Copland Avenue Wembley Middx HA0 2EN 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) 020 8733 0430 020 8733 0450 ccarehome@schealthcare.co.uk www.schealthcare.co.uk Southern Cross (LSC) Ltd Care Home 77 Category(ies) of Dementia (77), Old age, not falling within any registration, with number other category (77), Physical disability (77) of places Coplands Nursing Home DS0000022924.V365946.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 with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE 2. Physical disability - Code PD The maximum number of service users who can be accommodated is: 77 11th July 2007 Date of last inspection Brief Description of the Service: Coplands Nursing Home is a purpose built care home, which is owned by Southern Cross (LSC) Ltd, a national provider of care homes. It is situated close to Wembley, Middlesex. A variety of shops, banks, restaurants, and other amenities are located in Wembley and Sudbury, within a few minutes walk from the home. Public bus, and train transport facilities are accessible close to the home. The home has a large car parking area at the rear of the premises. The care home has a garden, and patio, which are accessible to people using the service. The home has accommodation for 77 people using the service in single bedrooms, which have ensuite facilities. It caters for people with a range of needs, and is divided into 5 units. Falcon unit is situated on the ground floor, and has 16 beds for people who have physical disability. Owl unit also on the ground floor has 9 beds, and also provides accommodation for people with a physical disability. This unit had recently provided accommodation for older persons, four of whom have chosen to remain there for the duration of their stay. Hawk unit is situated on the 1st floor and caters for the needs of frail elderly people using the service (20 beds). Eagle unit (15 beds) accommodates elderly service users with dementia care needs. Kestrel unit Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 5 (17 beds) specialises in the care of frail elderly Asian service users. The fees range from £575-£1500 per week. Additional charges are clearly recorded in the service user guide and in the residents’ contract/terms and conditions. The home provides people living in the home, and visitors with information about the care home, which is also available in Gujarati. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 6 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. The unannounced key inspection took place during two days in July 2008. During the first day of the inspection there were two inspectors carrying out the inspection. An ‘expert by experience’ was invited to take part in the inspection process, and accompanied the lead inspector on the second day of the site visit. An ‘expert by experience’ is a person who has a shared experience of using services, and can help an inspector get a better picture of what it is like to live in a care home. The ‘expert by experience’, who is Asian, spent several hours engaging with a number of Asian residents who live in one unit within the home. This particularly added value to the inspection in regard to gaining knowledge of the views, and experience of Asian people using the service. Key parts of the report written by the ‘expert by experience’ following this inspection, will be used as evidence to support judgements made in regard to the service provided by Coplands Nursing Home. Prior to unannounced key inspections the Commission for Social Care Inspection (CSCI) supply registered services with a Quality Assurance Assessment (AQAA) document. The AQAA is a self-assessment of the service provided by the care home that is carried out by the owner and/or manager. It focuses on the quality of the service, and how well outcomes for people using the service are being met by the care home. It also includes information about plans for improvement, and it gives us some numerical information about the service. Due to the Commission not having received an up to date email address of the home, the manager told us that she did not receive an AQAA document. The manager accessed this document just prior to this inspection, and supplied it to the Commission for Social Care Inspection promptly following the inspection. Information from this AQAA record will be documented in this report. The manager completed this document very comprehensively. A number of feedback surveys were supplied to the care home prior to this inspection. These requested feedback from people using the service, relatives/significant others, health and social care professionals, and staff. At the time of writing this report, we had received 12 completed surveys from people using the service, 11 surveys from relatives/visitors, 2 surveys from a staff, and 2 from health professionals. Information from these surveys will be included in this report. Following the inspection a relative of a resident was also spoken to about their views of the service. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 7 Other information received by the Commission for Social Care Inspection (CSCI) about the service since the previous key inspection was also looked at. This included what the service has told us about things that have happened in the service, these are called notifications, and are a legal requirement. The inspectors, and the ‘expert by experience’ spoke with a significant number of the people using the service, visitors, and staff on duty during the inspection. The manager was present during most of the inspection. Documentation inspected included, care plans of people using the service, risk assessments, staff training, and staff personnel records, and some policies and procedures. The inspection included a partial tour of the premises. Assessment as to whether the requirements, from the previous inspection had been met, also took place during this inspection. These were judged to have been met. 25 National Minimum Standards for Older Persons, including Key Standards, were inspected during this inspection. The inspector thanks the people living in the care home, staff, the manager, all those who supplied us with completed feedback survey forms, and the ‘expert by experience’ for all their assistance in the inspection process. What the service does well: The care home is welcoming, and purpose built. The ‘expert by experience’ reported that he had had a positive first impression of the home. A visitor spoke of the home having a nice ‘atmosphere’. Comments from relative/visitors feedback surveys included ‘There is always a calm atmosphere’, and the home has ‘a family atmosphere’, and ‘it is a marvellous home’. A unit in the home has been specifically decorated to ensure that the environment is attractive and meets the varied needs of people who have dementia. The care home has four activity coordinators who enable people using the service to have the opportunity to participate in a variety of ‘one to one’ and/or group activities. The expert by experience spoke highly with regard to the role of the activity co-ordinators. Comments from feedback surveys from people using the service included ‘I am happy with the religious activities’, and activities are ‘numerous and in all the units’, and ‘I always enjoy taking part in everything’. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 8 People are supported and encouraged to visit the care home before deciding to live in it. Comments included ‘I saw the home brochure, and I liked it and without hesitation I decided to come to Coplands, and I am happy here’, and ‘I came to view the home, so I knew how nice it was and the staff are wonderful’, and ‘I am happy here’. Meals meet the various religious, ethnic and vegetarian needs of people using the service. Comments included ‘the meals are very good, and everybody enjoys them’, and ‘I always enjoy the meals’. Staff receive a significant amount of ongoing, varied and appropriate training to ensure that they have the skills to understand, and meet the varied and multiple needs of people using the service. Comments from people using the service include; ‘the care is always very good and the people (staff) are always very caring’, and the ‘staff are always extremely helpful and kind’, and ‘the staff always help and advise in everything’. The manager is experienced and keen to develop and improve the service. She completed the Annual Quality Assurance Assessment (AQAA) very comprehensively, including information about what the home does well and of the plans for developing and improving the service. What has improved since the last inspection? Annual Quality Assurance Assessment information and inspection informed us that previous inspection requirements from the key inspection July 2007 had been met by the service. Information about the service is available in CD format; to enable residents who have difficulty in reading, gain information about the service provided by the care home. Several areas of the care home have been redecorated and some carpets have been replaced. Resident’s care plans have been reviewed and improved. The manager closely monitors their quality. People using the service have been encouraged and supported to communicate their views of the service and to be involved in the running of the home. The home has a regular newsletter in which residents contribute articles. The number and variety of activities have continued to be developed and improved. The procedures for the management of resident’s monies have been reviewed and improved, to ensure that people using the service receive interest on their savings. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 9 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 10 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 Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 11 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): Standards 1, 2, 3 and (6 is not applicable) People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who may use the service and their representatives have the information needed to decide whether the home will meet their needs. People using the service have their needs assessed prior to moving into the care home, which makes certain that the home knows about the person, and the support that they need. Some equality and diversity aspects of this assessment could be further developed. There is a written contract, statement of terms and conditions with the home for each person using the service, but some residents are not aware of this document. EVIDENCE: The care home has accessible documentation, and information about the service provided by the care home. It was evident that people using the Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 12 service have copies of this document. Copies were seen in the bedrooms inspected. Both the service user guide, and the statement of purpose are in written format, with some pictures. The manager spoke of being in the process of reviewing the service user guide. The home also has information about the organisation and the care home on CD/DVD format, which we were told could be accessed by people using the service and others. Further ways of making the service user guide more accessible to people using the service was discussed. The manager spoke of continuing to work with residents to improve the format of the service user guide. This is positive. A comment from people using the service included ‘I saw the home brochure, I liked it, and without hesitation I decided to come to Coplands, and I am happy here’. The home has an admissions policy/procedure. Annual Quality Assurance Assessment (AQAA) documentation informed us that the home completes a comprehensive pre-admission assessment of the needs of all prospective residents. This could include a specialist assessment such as assessment of a person’s dementia care needs. The manager/owner spoke of having knowledge, and understanding of the importance of carrying out a comprehensive initial assessment of a prospective resident. She spoke of the process of this assessment. The manager or a designate undertakes assessments. The initial assessment includes talking with and fully involving the prospective resident in their assessment. One of the people we spoke to informed us that he can remember being involved in their initial assessment. Further assessment information may be gathered from hospital nursing staff, and/or relatives/significant others (when agreed by the person) when appropriate. The manager reported that there was an ‘on-going’ assessment of the person’s needs, during their ‘settling in’ period, prior to permanently living in the care home. All assessed care plans had detailed assessments in place. Assessments are done holistically looking at the physical, emotional and mental health needs of the person. These assessments included some assessment of religious and cultural needs, and some information with regard to sexuality needs. Further development of recorded assessment of some areas of equality, and diversity needs could be more evident to ensure that the care home shows a comprehensive understanding, and respect for all aspects of diversity including gender, age, sexual orientation, race, and disability. The manager told us that the home encourages people to visit the home before moving in. She spoke of a resident, who was a patient in hospital, having visited the home prior to moving in. We were told that another person using the service had stayed for three days in the care home before deciding to Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 13 move into the home. A comment from a resident was ‘I came to view the home, so I knew how nice it was and the staff are wonderful’. We were told that all residents have contracts/statement of terms and conditions. The feedback survey forms informed us that a significant number of residents were not aware of this document. The manager told us that the relatives sometimes sign these documents when residents are unable to do so. The manager should ensure that all residents have a copy (if they wish) of their terms and conditions document. It should be recorded in the care plan the reasons for a resident not signing their contract with the care home. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 14 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): Standards 7,8,9, and 10 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Each person using the service has a plan of care, in which residents’ health, personal, and social needs are set out. People using the service are respected and their right to privacy upheld. People using the service are protected by the home’s policies and procedures for managing and administrating medication. EVIDENCE: Each person using the service has a plan of care. Ten care plans were inspected. It was evident that the care plans had undergone considerable review since the previous key inspection, and all are based upon the assessed needs of each individual person. Three residents told us that they had seen their care plans. The care plans included information about the life history of the person, cultural, medical, dietary needs and preferences, sight, hearing, preferred form of address, communication, oral health, foot care, mobility, history of falls, Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 15 continence, and personal safety. These care plans included recorded staff guidance for meeting each person’s assessed needs. It was evident that this guidance was reviewed in accordance to the changing needs of people using the service. Care plans inspected informed us that care plans are reviewed on a monthly basis. Six monthly review meetings also take place, which are attended, by family members, social workers, key workers, resident and manager or named nurse. We noted that some daily records are incomplete or not correct. For example one person was able to dress herself in July 2008, but until the 30/06/08 needed assistance. Staff asked told us that the person is still in need for assistance. Some records are incomplete due to space running out on the form and nobody replacing the form with a new one. This was discussed with the manager, who explained to us that the person in charge of the unit should replace forms. The manager told us that she has started to audit all care plans. We found two such audits, and judged the audits to be detailed and believe that once this is completed it will improve the care planning process for people using the service. AQAA information told us that the manager plans to develop and improve the role of the key workers in ensuring that they are ‘adequately prepared and trained and supervised to carry out their role. Individual ‘daily’ and night progress records are documented by staff. Records, residents and staff confirmed that the home has a good understanding of people’s religious and cultural needs. The expert by experience confirmed this from having spoken to residents, an activity coordinator and been shown the facilities (i.e. the spiritual room) available for supporting people to practice their faiths. The manager spoke of her plans to provide more staff training in regard to equality and diversity needs of the people using the service. To further develop understanding of all six strands of equality and diversity (race, age, gender (including gender identity), sexual orientation, disability, religion and belief), and to document this in the care plans and assessments of people using the service. The AQAA information told us that the home has also supported the ‘Dignity challenge’ (promoting the dignity of people using the service), which has been discussed with staff in supervision sessions. Care plans include risk assessments, such as risk of falls, use of the stairs, nutritional needs, road safety, pressure area care, moving and handling, and bathing. The risk management plan is reviewed monthly and has been updated were necessary. For example one person does not require any support around self-care, this has been recorded in the risk assessment. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 16 One of the care plans we viewed recorded that the person needs bedrails during the night. The person has given consent to this and the use of bedrails has been risk assessed. Nutritional and fluid intake is recorded daily, but as noted earlier some of these records are incomplete. We viewed in all care plans detailed pressure sore assessments, which have been reviewed. AQAA information told us that the care home provides ‘pressure relieving equipment to people using the service, and has an internal link tissue viability nurse’. We were told that there is close monitoring of any pressures sores. Resident’s personal care needs, and preferences are recorded in the care plans. This record includes the level of assistance (with regard to resident’s personal care needs) needed to be given by care staff. Staff spoke of their role in supporting residents with their personal care, which included ensuring that resident’s dignity and privacy were respected. During the inspection, staff provided assistance and support to residents in a sensitive and respectful manner. It was evident from observation and from talking with staff that they have an understanding of the importance of upholding resident’s right to privacy. A resident spoke of making choices, which included choosing her own clothes, and the time she wished to go to bed, and get up in the morning. Residents preferred routines are recorded in the care plans inspected. People were observed to be dressed appropriate to their culture and age. Care plans included evidence of people’s choice being acknowledged, and staff guidance (to meet these needs) was incorporated into their plan of care. We spoke to people using the service who told us that they are treated with respect and staff always knock before they are entering a room. Records, staff, residents, and feedback surveys told us that people using the service have access to care, and treatment from a variety of health professionals, and specialists. These include GP, dentist, continence advisor, community nurse, and chiropodist. AQAA information told us that the home employs a physiotherapist. A resident told me that he/she had ‘seen the doctor’. We were told by staff that the GP reviews the needs of residents on a monthly basis, and makes referrals to specialists as and when required by people using the service. Comments from feedback surveys completed by health professionals included the service is ‘working well’, ‘Coplands is a good care home and always contacts me when a patient has a (specialist healthcare) need’, and the care home ‘always makes me welcome and attends patients with me’. A relative told us that their family has all their “medical problems picked up”. One relative feedback survey commented upon their relative’s ‘uncommon illness’, and recorded that ‘Coplands has been responsive to learning’, about the illness. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 17 The home has a medication policy/procedure. Medication is stored securely. Controlled drugs are stored separately in a lockable cabinet. Records are correct and signed by two people. The registered nurses on duty administer the medication to people using the service. We were told that the medication administration records are checked daily. There is recorded guidance signed by the GP with regard to the administration of homely remedies. We were told that all staff receive medication training from a pharmacist, and that all nursing staff are in the process of completing the ‘Certificate in Medicine Management’ course. The manager and a nurse spoke of residents having their medication regularly reviewed by the GP. Staff informed us that weekly audits of the medication administration and storage systems are carried out. The home has copies of up to date British National Formulary (BNF) from a pharmacist. This details medicines prescribed in the UK, with special reference to their uses, cautions, contra-indications, side effects, and dosage, which is useful for reference to staff working in the care home. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 18 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): Standard 12,13 14 and 15 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have the opportunity to take part in a variety of preferred activities. The visiting arrangements are flexible and meet the needs of visitors and residents, so as to ensure that residents have the opportunity to develop and maintain important relationships. Meals provided are varied, and wholesome, and meet the cultural and faith needs of people using the service. EVIDENCE: The home employs four activity coordinators. The ‘expert by experience’ commented (following observation on one unit) that an activity coordinator’ was very popular amongst the people using the service. Each unit within the home has an activity programme. This was seen to be displayed in fairly small print in each unit. We spoke to three activity coordinators who informed us that they would tell each resident during the morning what activities are planned for the day. Several residents spoken to were not sure what activities were to be provided during the day of this key Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 19 inspection. We recommend reviewing the way residents are informed of daily activities. The format of these programmes was discussed with the manager. She spoke of the plans of the activity coordinators to make the information more accessible to residents. Some development/improvements were made during the inspection. These included adding some pictures to the documents, and putting up notice boards on the units to display daily information about activities available for residents to participate in. A sensory activity room is accessible to people using the service. The ‘expert by experience’ described this room as having a ‘stunning display of colourful lights’, which residents could ‘enjoy’. Staff told us that the sensory room was used everyday. We were told that residents have access to a digital television service. Records informed us that people using the service participate in a variety of activities. These include arts and crafts, ball games, sewing, reminiscence sessions, ball games, dominos, word games, Gujarati song sessions, and memory card games, Bingo, current affairs, and keep fit. Photographs of residents, and staff, taken during recent outings and activities were displayed in the home. These included a multi cultural day, a trip to London zoo, a picnic in the park, and a Halloween party. A garden party recently took place in the home. Other entertainment included Shivratri Bhajans, Valentine’s Day entertainment, St Patrick’s Day, and St George’s Day celebrations and a variety of Easter activities. Entertainment from an Ethiopian music band was also provided. We were told that there were plans to celebrate the tenth anniversary of the opening of the care home, and that there were plans for a designated Asian garden. One resident told us that the home is planning a trip to Brighton in July 2008. The ‘expert by experience’ and lead inspector were told by staff that there had been some difficulty in accessing transport for day trips, and other outings. The manager spoke of the home now being able to access a suitable vehicle from another of the organisation’s care homes. This is positive. Community based activities for people using the service should be further developed, enabled and supported by the care home. AQAA information informed us that there were plans to ‘provide more opportunities for outdoor activity provision’. Comments from feedback surveys from people using the service included ‘I am happy with the religious activities’, and activities are ‘numerous and in all the units’, and ‘I am pleased with the organisers and the activities’, and ‘If I am not feeling well, I can not take part, but the activity coordinator is always arranging activities to my liking in my room. There was some evidence that some resident participated in some ‘employment’ in the care home. We observed one person clearing the dining table after lunch and later on helping the handy man moving boxes. We feel Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 20 that this should type of occupation could be explored more (particularly with regard to the younger adults) and the person should be encouraged to choose meaningful activities/employment, which increase and/or improve skills that they may have had prior to moving into the care home. ’ Records, staff and a resident confirmed that religious/spiritual needs of people using the service are identified, and met. The home has a multi faith prayer room on one unit, that is available to residents and their visitors, and staff. Residents spoke of the importance of practising their particular religion. A resident showed me a religious shrine that she had in her bedroom. The visitor’s record book indicated that people regularly visited the home. Residents spoke of visitors that they had had. We spoke to visitors during this inspection, who told us that they are happy how their relative is looked after, and that the home is communicating changes in their care to them. Comments from a relative feedback surveys included ‘ I am always telephoned, and then we discuss if the problem needs my attendance’, and ‘I have always been informed of problems’. Some feedback surveys from relatives/significant others commented that interaction between care staff and relatives and residents could sometimes be better; ‘a few kind words would make all the difference’, and ‘it would be nice to suggest to my relative that he might like to phone sometimes’. AQAA information told us that the manager intends to ensure that ‘we assist people who use the service to use the portable telephone, to make contact with friends and relatives’. Comments from people using the service included ‘I get visitors, my (relatives) and friends visit me’. A resident spoke of her family member visiting her regularly. The ‘expert by experience’ reported that a person using the service had said that ‘My sons come to see me regularly’. A person spoke of receiving regular telephone calls from family members, and of having a telephone in her/his bedroom. The home has a menu. This is displayed in each unit, and on dining tables, and in the foyer area of the home. We asked some residents if they are able to choose their meals and some people told us that they are not able to do so. Staff informed us that some people are unable to read. The accessibility of the menu to people using the service could be improved, for example it could be better displayed and include photographs of meals, and/or other pictorial format. This could help in informing and reminding people using the service of the choice of meals planned to be served to them that day. Food eaten by residents is recorded and their weight is monitored monthly and if there is reason to concern more frequently. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 21 There are two kitchens, a general kitchen facility and a vegetarian kitchen. Meals provided during the inspection were as recorded on the menu. We were informed by the manager, and records that the home has recognition from a vegetarian organisation with regard to its provision of vegetarian meals, and that following feedback from residents, the menu, was recently reviewed and changed to incorporate more of the resident’s food preferences. The ‘expert by experience’ confirmed that residents ‘in accordance with their religious beliefs were served with vegetarian food consisting of pulses, vegetables, rice and chapattis’, and that ‘the menu seemed to be very appropriate considering the age and physical condition of most of the clients’. He commented that ‘most (residents) expressed their satisfaction with the quality of the food’, and that a resident had said ‘there was no excess oil in my vegetables and I liked it (the meal)’. We spoke with the chef who cooks the vegetarian meals, she told us of her role in ensuring that residents receive meals that meet their needs and preferences. The expert by experience and the lead inspector sampled a vegetarian meal provided to some Asian residents. Both agreed that this was a pleasant meal. The ‘expert by experience’ commented that another chef cooks ‘halal meat for residents at floors one and two’, and that she told us that ‘I make my own yogurt without the use of chemicals’. The ‘expert by experience’ concluded that the cooks had a ‘commitment to serve the best interest of the residents’. We were informed from AQAA documentation that at a recent residents meeting, residents were asked to put forward their suggestions on how to improve the supper menu. Generally residents were pleased with the quality of the meals provided. Comments from feedback surveys included; included ‘the meals are very good, and everybody enjoys them’, and ‘I always enjoy the meals’. Breakfast and lunch meals were observed during the inspection. It was evident that there could be improvement in the ways the meals are presented in some units. Dining tables could be more attractively laid. Napkins/serviettes should be easily available for residents without them having to ask. It was observed that a resident(with significant communication needs) did not start to eat her breakfast until a staff member recognised that this resident was waiting for a napkin. When this was provided the resident smiled broadly and started to eat her/his breakfast. There were some residents seated at a dining room table. They had their toast given to them folded like a sandwich. Residents should be assessed as to whether they can spread butter on their toast, spread marmalade, pour there own tea etc. Fruit juice was not seen to be offered to some residents. Though there was a jug of squash seen. In another unit (for people with a physical disability) people were observed to be encouraged to butter their own toast and fruit juice was on the table to use. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 22 We observed lunch in the Owl unit; the meal was nicely presented and correspond to the menu. We asked residents if they are able to choose their meals and some people told us that they are not able to do so. A menu is displayed in both ground floor units, but staff informed us that some people are unable to read. Staff confirmed that residents had a choice of meals, and spoke of the particular food preferences and dietary needs of several people using the service, and of how these are met by the home. Food ‘likes’ and ‘dislikes’ were recorded in care plans inspected. Some residents were assisted with meals. This was carried out sensitively by staff, who sat beside the resident during the meal. The manager confirmed that staff receive training with regard to assisting residents with eating their meals. Staff in the Owl unit informed us that seven out of nine residents require assistance around meals. One person was assisted one hour after the others. We recommend reviewing the staffing numbers to enable people to eat together. The manager spoke of reviewing staffing numbers regularly, and told us that steps had been taken to resolve this issue. Meals were judged to be wholesome and nutritious, and included fresh produce. Fresh fruit was available. Some residents have fresh fruit in their bedrooms. Hot and cold drinks were regularly provided to residents during their meals and throughout the inspection. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 23 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): Standards 16 and 18 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People using the service and others are confident that their complaints will be listened to, looked into and action taken to put things right, but there could be development in the recording of “comments/concerns”. Residents are protected from abuse, neglect and self-harm. EVIDENCE: The care home has a complaints procedure, a summary of which is recorded in the service user guide. The complaints procedure includes timescales with regard to responding to a complaint. AQAA information told us that the ‘home has a policy of being open and transparent’ and that ‘a monthly log and review of any complaints is maintained’. Comment slips about the service are accessible on the units. So residents and visitors can provide feedback in regard to their views of the service. Visitors confirmed that they know how to make a complaint. The manager/owner spoke of the ways that she and the staff team respond to ‘concerns’/complaints from people using the service, and others. She confirmed that she was continuing to improve the systems and practices of recording any ‘concerns’. AQAA information told us that the home will ensure that all staff read the complaints procedure regularly, and will act promptly when ‘any concerns arise, regardless of how small or insignificant the concern may be, and to assist in the resolution immediately’. The manager told us that Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 24 she had plans to be provided with a daily report of any ‘concerns raised’. This is positive. Comments from people using the service confirmed that if they were unhappy they would speak to the nurse in charge or manager. Comments from feedback surveys included ‘I have no concerns at all’, and ‘I have always been able to approach staff or the manager’. Residents and relative feedback surveys confirmed that they generally know how to make a complaint, but two residents and two relatives informed us that they did not know the complaints procedure. This was discussed with the manager, who spoke of her plans to ensure that all stakeholders including residents know the process of making a complaint. Feedback surveys and talking to visitors confirmed that the care home has responded appropriately when ‘concerns’ and or complaints are raised. ‘ The home has a protection of vulnerable adults policy, and whistle blowing policy. It also has the lead local authority safeguarding procedure. Staff who spoke to us were knowledgeable of the reporting and recording of complaints, and of the procedures with regard to responding to an allegation or suspicion of abuse. Staff confirmed that they had received training in abuse awareness. AQAA information told us that ‘training is being provided to staff in regards to safeguarding adults and the procedures for dealing with any allegations under local and national procedures, and the Mental Capacity Act.’ Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 25 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): Standard 19, 23, and 26 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The environment of the home is safe, warm, clean and comfortable. The premises are suitable for the care home’s stated purpose. Resident’s bedrooms, are individually personalised and meet their individual needs. EVIDENCE: The home is purpose built. It is located within a few minutes walk from central Wembley, and close to a variety of amenities including shops, restaurants, banks, and cafes. Public train and bus transport facilities are accessible close to the home. The expert by experience agreed that the care home is welcoming. Feedback surveys from relatives included the comment that the home keeps ‘a calm and tranquil environment’, and ‘there is a family atmosphere’. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 26 The front of the property is generally tidy and attractive, with a number of potted flowers located near the entrance. The grass area along the fence of the care home (near the car park) was ‘weedy’ and long, and could be cut. The main garden area is enclosed and well kept. It contains a variety of flowers and other plants and shrubs, and includes a religious shrine. Seating is accessible to people. Residents told us that they enjoy the garden facility and access it frequently during nice weather. The home is generally well maintained, and some areas of the home have been redecorated, and some carpet laid, since the previous key inspection. The home employs a maintenance person. AQAA information told us that ‘a redecoration programme is well under way’, and that ‘many aspects of the home will be refurbished and redecorated over the next twelve months’. There are some areas of the home that could do with being some redecoration. These include some bathrooms. The ‘expert by experience’ commented that some bathrooms ‘need re-flooring’. Upon arrival into the home there was a slight unpleasant odour that was noticed by both inspectors. This was less apparent later on in the day. This was an issue that had been brought to the Commission for Social Care Inspection’s attention by a visitor, earlier this year. Action was taken by the manager following the care home’s complaints procedure. The manager told us that this odour sometimes occurred (particularly in the mornings) due to the particular behaviour/personal care needs of a person using the service. The manager confirmed that she would seek ways of ensuring that there was never an unpleasant odour in the care home. One unit has been specially decorated to meet the dementia care needs of people using the service. It included various materials secured on walls that residents could touch as and when they wished. Staff told us how several residents had become less anxious since the unit had been decorated, and were less likely to want to ‘wander’. This is positive. The living environment is appropriate for the particular lifestyle, and needs of people living in the home. Photographs and pictures, and plants are located in the communal sitting/dining room areas of the home. Some residents kindly showed us their bedrooms, which include ensuite bathroom facilities. These were individually personalised, with lots of photographs, and ornaments. Several residents have there own telephone and television. People using the service spoke positively of their bedrooms. Comments included ‘I’m happy with my room’. In one unit the names recorded on people’s bedroom doors were written in Gujarati as well as English. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 27 We were informed that due to’standing’ hoist equipment not working, two units had to share a hoist. The manager confirmed that the home was awaiting a part for this equipment, and that it would be repaired as soon as possible. We were also informed that a microwave oven located in the Asian kitchen, is not working, and a washing machine in the laundry needs repair. The home has an infection control policy/procedure. Laundry facilities are located away from food storage, and food preparation areas. A comment from one relative survey included ‘personal clothing gets lost’. The laundry staff member was spoken with during the inspection. He spoke of several improvements having been recently made to the laundry service, but that there were still some occasions when clothes are not marked, and that clothes are not always placed in the appropriate laundry bags, which causes problems such as clothes going ‘missing’. Closer liaison with the care staff on the units with regard to resident’s clothes was discussed. The manager confirmed that she would meet with the laundry staff member and other staff to examine ways to minimise the risk of people using the service ‘losing’ their clothes during the process of laundering them. Hand washing facilities are located throughout the home. Alcohol gel dispensers for hand cleaning are accessible. There are accessible paper hand towels and soap in bathrooms inspected. The ‘expert by experience’ commented that he had ‘noted that the cleanliness and housekeeping well met the standards expected in care homes’. A comment from a person using the service included ‘the home is always clean’. Staff were observed to wear protective clothing including disposable gloves, as and when needed. Records confirmed that staff had received infection control training. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 28 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): Standard 27,28 29 and 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and competent to support people who use the service, and the smooth running of the service. People using the service are supported and protected by the care home’s recruitment policy and procedure. EVIDENCE: The staff rota was available for inspection. We were told that the number of staff on duty in each unit varies according to the dependency levels of the people using the service, and that these were kept under review (see daily life and social activities section with regard to supporting residents with their meals on Owl unit). Staff spoke positively of working in a team, and of enjoying their job. During the inspection staff worked well together. Staff were observed to be very approachable and interacted with residents in a particularly sensitive manner during the inspection. They spent a lot of time talking with people using the service, sitting with them and assisting them promptly with their personal care needs. Visitors commented that staff were ‘lovely’. Comments about the staff from people using the service included A resident commented that the staff ‘do their best’, another resident said that ‘I love it here, the nurses are fantastic’. Feedback surveys from residents Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 29 included comments ‘the care is always very good and the people (staff) are always very caring’, and the ‘staff are always extremely helpful and kind’, and ‘the staff always help and advise in everything’. Comments about the care home received from relative’s feedback surveys were generally very positive about the service provided to their friends/family members. These comments included that the care home provides ‘marvellous care and full time attention’, and ‘my relative is now enjoying her life looked after and cared for 24/7’ and ‘I am very happy with the care all the staff carry out (for) my relative and I am always made welcome’, and ‘you always get a welcome response from staff’. Some commented that there were times when call bells are not answered promptly’. During the inspection it was evident that there were times when there was a few minutes delay in call bells and the telephone being answered. This was discussed with the manager, who told us that the staffing numbers on each unit are reviewed regularly, and that she was presently reviewing the afternoon staffing numbers on units, and would continue to monitor call bells being answered. The call bell system could be reviewed with regard to the issue of whenever a call bell is used; the sound from it is heard in every unit, which could be disturbing to some residents. There was some feedback from people using the service and from relatives that indicated that some staff could improve their interaction with people using the service, comments included ‘I (would) like it and love it if all the carers talk to me with a smile on their face’, and ‘just a few kind words would make all the difference’, and ‘some care staff lack kindness and a polite approach towards patients’. This was discussed with the manager who spoke of the training that was carried out with regard to appropriate and positive staff interaction with people using the service. She confirmed that she would promptly provide further training to staff with regard to this. Staff were positive about their jobs and told us that the home provides good induction training, and other training to ensure that they have the essential skills for carrying out their roles and responsibilities. Staff training included, medication training, fire awareness, First aid, manual handling, health and safety, food and hygiene training, dementia care and ‘managing challenging behaviour’ training. Certificates of staff training were accessible in the staff personnel files. AQAA information told us that ‘several staff members have undertaken additional palliative care training to facilitate responsive provision of end of life care’, and that there were plans to provide ‘staff with a personal training needs analysis so that the management can highlight individual training needs’. Also that the home plans to train two trainers in Alzheimer’s Society training, who will cascade training to staff. Information with regard to forthcoming staff training sessions were displayed in the care home. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 30 Staff confirmed that they have the opportunity to achieve National Vocational Qualifications (NVQ) level 2 care. AQAA information told us that 54 of staff have achieved this qualification, and that the home has accessed a local study centre to provide NVQ training and distance learning for staff. We were told that ancillary staff have also completed NVQ level 2 standards. Two staff members confirmed that she had achieved an NVQ level 2-care qualification. The care home has a recruitment and selection procedure. Three staff personnel files were inspected. These contained confirmation that staff have received an enhanced Criminal Record Bureau check to gain information as to whether potential staff have a criminal record. AQAA information informed us that all volunteers follow the same recruitment and selection procedures. The home has a recorded staff code of conduct, and equal opportunity policy/procedure. Staff job descriptions were available for inspection. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 31 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): Standard 31,33,35, 36, and 38 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect, and has effective quality assurance systems to monitor and improve the quality of the service provided to people using the service. So far as reasonably practicable the health, safety and welfare of people using the service is promoted and protected, and their financial interests are safeguarded. EVIDENCE: The manager had managed the care home since March. She is a registered nurse, and holds several qualifications including a postgraduate diploma in Geratology, BSc (Hons) Nursing Studies and the Registered Manager’s Award. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 32 She has significant experience having worked for 19 years in the private healthcare sector. The manager confirmed that she would be submitting an application to be registered with the Commission for Social Care Inspection. Following conversing with the manager the ‘expert by experience’ commented in his report that ‘the manager was well aware of the issues like safety, emergencies, welfare of staff and clients and their special ethnic requirements, entertainment, and changing needs of the individual (residents)’. Comment from relatives feedback surveys included ‘I have noticed an improvement all around, I am satisfied with all’, and ‘there have been noticeable improvements over recent months’ It was noted that during the inspection that the manager visits each unit during her shift, and speaks to residents and staff. . It was evident from AQAA information and from talking to the manager that she has a significant number of plans to develop and improve the quality of the service provided to residents, with their (and other stakeholders) full involvement. We were told that a representative of the organisation carries out monthly audits of the quality of the service. AQAA information told us that the home plans to develop an annual business development plan for the service. Records, staff and a resident confirmed that people using the service have the opportunity to participate in regular resident meetings. Staff meetings also take place. The home produces a regular newsletter, which includes contributions from people using the service, and is available to residents and visitors. The care home has a number of systems in place to ensure that the quality of the service is monitored closely and that action is taken to continue to develop and improve the service provided to people using the service. AQAA information told us that questionnaires are circulated to people who use the service, and that an action plan for the home is then formulated, to ensure that action is taken in response to their views. The care home has recently reviewed its procedure with regard to the management of ‘residents personal monies’. Records confirmed that residents have an individual financial assessment. Most residents have the finances managed by relatives/significant others, but the home (with monitoring from the organisation) does manage some resident’s allowances. There are robust systems in place to ensure that each person using the service has an individual account and receives interest on their money. Records confirmed that comprehensive recording of deposits and expenditure is carried out. AQAA information told us that financial audits of residents’ monies are completed monthly. The home has a staff supervision policy. Staff confirmed that they receive regular staff one to one staff supervision, which ensures that they are Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 33 supported in carrying out their role and responsibilities for meeting the care and support needs of people using the service. A record of recent staff supervision was seen. AQAA information told us that staff receive annual appraisals. The home has health and safety policies and procedures, and risk assessments (including kitchen safety, and use of household products) to ensure staff and residents are protected and safe. Fire safety guidance is displayed in the home. Required fire safety checks and fire drills are carried out, and there is a fire risk assessment. Fire safety guidance is displayed. The home lets us know about things that have happened; they have shown us that they have managed issues appropriately. The home has an accident policy/procedure. Incidents and accidents are recorded as required. Records confirmed that the manager and organisation monitors accidents/incidents closely. The home has an up to date displayed employer’s liability insurance certificate displayed in the care home. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 34 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 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 3 X X 2 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 3 X 3 Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 35 Are there any outstanding requirements from the last inspection? NO 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 OP8 Regulation 17(3) Requirement Timescale for action 01/09/08 2 OP19 23(2) 3 OP26 16(2)(k) 4 OP31 8 CSA Part11 11(1) The registered person must ensure that all daily records are monitored and missing forms are replaced without delay. This is to ensure records are up to date and staff are aware of changes in peoples needs, so that they can respond as quickly as possible. The microwave oven located in 01/09/08 the Asian kitchen, a washing machine in laundry, and the hoist aid, which are not working need to be repaired. The registered person needs to 01/10/08 seek ways of ensuring that there is never an unpleasant odour in the care home. The manager needs to be 01/12/08 registered with the Commission for Social Care Inspection. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 36 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 OP2 Good Practice Recommendations The manager should ensure that all residents have a copy (if the wish) of their terms and conditions. It should be recorded in the care plan the reasons for a resident not signing their contract with the care home. Further development of recorded assessment of areas equality, and diversity needs could be more evident to ensure that the care home shows a comprehensive understanding, and respect for all aspects of diversity including gender, age, sexual orientation, race, and disability. The registered person should discuss with residents and activity co-ordinators how activities could be advertised more prominently. This allows all residents to know what activities are provided and make a choice if they want to take part in activities. The registered person should discuss suitable employment activities with all residents who are able to do so. Community based activities for people using the service should be better developed, enabled and supported by the care home. The manager should ensure that she reviews the quality and amount of some of the cooking equipment such as the food liquidiser, cooking plans and chopping boards. The accessibility of the menu to people using the service could be improved, for example it could be better displayed and include photographs of meals, and/or other pictorial format. People using the service should be involved as much as they are able in this process. This could help in informing and reminding people using the service of the choice of meals planned to be served to them that day. 2 OP3 3 OP12 4 5 6 OP13 OP15 OP15 Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 37 7 8 9 OP16 OP19 OP27 10 OP27 11 OP30 There could be improvement in the ways the meals are presented in some units. The home should ensure that all stakeholders including residents know the process of making a complaint. There are some areas of the home that could do with being redecorated. These include bathrooms, and bathroom flooring. Staffing numbers on Owl unit should be regularly kept under review, to ensure that they always meet the dependency needs of people using the service, particularly when people require assistance with their meals. There should be monitoring of the time that call bells are answered by staff, to ensure that resident’s needs are promptly met. The call bell system could be reviewed with regard to the issue of whenever a call bell is used. The sound from it is heard in every unit, which could be disturbing to some residents. There should be further staff training carried out with regard to ensure that there is always appropriate and positive staff interaction between staff and with people using the service. Coplands Nursing Home DS0000022924.V365946.R01.S.doc Version 5.2 Page 38 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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. 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