Care Home: Copper Beeches

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What the care home does well The manager and staff always make sure that this is the right home for people before they decide to move in, by assessing their needs making sure these can be met. The management team are good at making sure the staff are trained and supported to do their jobs. The service users said that they were generally pleased with the care and the staff. The service users and their families can be assured that if there are concerns the manager will do all they can to put things right. The service users and their relatives said they like the home and that it is comfortable, especially since the refurbishment. Relatives commented on how much they like the sitting room because it has small separate areas, which provide privacy. The manager has plans to continue to improve the amount and type of activities that people can take part in if they choose to. What has improved since the last inspection? During the last inspection we asked the manager to make sure that all medication was recorded properly, and this is now being done. We also asked for the staff to be trained to deal with suspicions of abuse, this has been done and the staff were clear about what they would do. The home has been refurbished and there are further plans to improve the facilities. The manager has made the following changes since the last inspection as a result of listening to people who live in the home; People can now choose to have their breakfast earlier. There are meetings for family and friends. A bathroom has been changed to a shower room. There is more musical entertainment. There is now a small, quite sitting room. The staff ask for more information about what people would like to do to keep them active. CARE HOMES FOR OLDER PEOPLE Copper Beeches Woodlands Way London Road Andover Hampshire SP10 2QU Lead Inspector Kima Sutherland-Dee Unannounced Inspection 22nd May 2008 08:35 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 Copper Beeches DS0000037292.V363546.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. Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Copper Beeches Address Woodlands Way London Road Andover Hampshire SP10 2QU 01264 353703 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) glynis.addington@hants.gov.uk Hampshire County Council Mrs Glynis Rosalind Addington Care Home 42 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0) of places Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 42. Date of last inspection 29th May 2007 Brief Description of the Service: Copper Beeches is a local authority residential home, registered for forty two service users in the categories of old age, not falling within any other category, and dementia care for service users over the age of sixty five. The home is situated in a quiet residential area of Andover, within easy reach of local amenities. Accommodation is arranged on two floors, with passenger lift access. Since the last inspection the home has admitted more residents with dementia. There are two five bedded ‘units’ or ‘flats’ which although still part of the home, are self contained. Existing residents who are more independent and do not have needs associated with dementia live in these flats. The current fees are £455 a week. This information was provided on the day of the inspection. Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 Star. This means the people who use this service experience good quality outcomes. The inspection included a site visit to the home over a period of six hours and fifty minutes. During this time we spoke with the manager, staff and people who live in the home, as well as visiting relatives and a care manager. We spent one hour over lunch observing the care provided, to be able to make a judgement about the experience of people who live in the home. Care plans, training records, policies and staff records were sampled. Other information used to make judgements about the standard of care in the home included the last inspection report and information received from the home, including their Annual Quality Assurance Assessment (AQAA) which was completed by the manager. This was received within the timescale requested by the Commission. These sources of information have been referred to throughout the report. We also received 5 ‘Have Your Say’ surveys completed by the service users. What the service does well: The manager and staff always make sure that this is the right home for people before they decide to move in, by assessing their needs making sure these can be met. The management team are good at making sure the staff are trained and supported to do their jobs. The service users said that they were generally pleased with the care and the staff. The service users and their families can be assured that if there are concerns the manager will do all they can to put things right. The service users and their relatives said they like the home and that it is comfortable, especially since the refurbishment. Relatives commented on how much they like the sitting room because it has small separate areas, which provide privacy. The manager has plans to continue to improve the amount and type of activities that people can take part in if they choose to. Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,5. Quality in this outcome area is good. People benefit from having the information they need to make an informed choice about moving to the home. They are assured the home can meet their needs after an effective assessment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two new assessments of prospective service user’s needs were seen, and these contained detailed information to inform the manager whether they can meet people’s needs. We spoke to a visiting care manager who said that the manager visited people in their own homes or in hospital to do assessments. The care manager also said that they value the manager’s opinion about whether this home was the right place for people. Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 9 Each person is offered the opportunity to visit the home before they decide to move there. Once they have moved in the manager uses the initial assessment to make a care plan. After a service user has lived at Copper Beeches for 4 weeks a review meeting is held to look at that persons care. The care manager said that the person they were supporting had settled in well. The homes own assessment (AQAA) states that the home has continued to make improvements to the pre-admission assessment and that they make sure every person has all the documents they need prior to, and after admission. A relative said their family member had been very settled since their recent move to the home. They said ‘We looked at other homes but this had the best atmosphere.’ Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is good. The care plans are detailed and they ensure that the staff are aware of each person’s needs. The service users have all their health care needs met and medication is administered safely. The service users usually experience respectful and dignified care and where this is not the case the manager will make improvements. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is trying new care plans and some of these have been completed. All of the current plans are individual and they give the staff the information they need to provide the care for each service user. The plans give the staff information about a person’s past history and what their normal routines are. The homes AQAA states that they make sure the service users or their representatives agree with the care plan and that they understand that the written plan informs the care they need. Where possible these plans have been signed by the service users. Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 11 The key workers for each service user review the care plans monthly. This means they are kept up to date and staff are aware of any changes in a person’s routine or care. Five care plans were seen and they record detailed information about how the staff meet peoples needs. They detail people’s physical health but also their emotional wellbeing, any activities they have taken part in and what care has been provided for that person each day. The care plans include a wellbeing form and this is used as a checklist for the staff so they remember important items such as making sure people have their glasses, dentures, hearing aids and the right footwear. The care plans include risk assessments that assess service user’s nutritional needs, what is being done to minimise the risk of people falling and whether people need extra care or equipment to prevent pressure sores. The records show that medical care is sought as it is needed and the manager said that the district nurse visits the home most days. A relative said that the staff always keep them informed about their family member’s wellbeing and they were very pleased with the care. Service users made comments about the care, these included, ‘I think it’s very nice’ ‘Most of the staff are good’ ‘The staff are pretty good, my carer is a lovely women.’ ‘The carers always knock on my door’ We spent an hour at lunchtime observing the care staff. This gives an opportunity to see how the staff interact with the service users and whether they are getting the help and support they need in an appropriate way. We noted on entering the dining room that one member of staff spoke very sharply to a service user, and when this staff member was helping a service user to have their lunch this was done inappropriately, without thought for the person’s dignity. However the rest of the staff were extremely caring, they took time to sit and talk to people, they helped people with their meals and they were extremely patient and respectful. The manager was made aware of the incidents at lunchtime and they assured us that they would investigate and take action. We observed a senior member of staff administering the medications. This was done correctly and the homes own procedure was followed when one service user refused to take their medication. Staff said they had regular training in giving medicines safely. We spoke to visiting relatives who were generally very positive about the care at the home. They said that ‘She’s well looked after here they’d do anything for you.’ Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 12 ‘ My relative has put on weight since they came here and the staff have been very good.’ A relative did comment that their relative’s key worker wasn’t good and that their laundry hadn’t been looked after, causing some damage. They will speak to the manager and the manager is aware that this is the same member of staff who acted inappropriately during lunchtime. Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. Service users benefit from being able to make choices and by having access to a wide range of individual and group activities that continue to be improved. The service users are offered meals that they like and that meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The previous report said that the service users could make decisions about their care and how they spend their time. We noted that this was still happening, and the manager stated in the AQAA that they want to improve this by offering more individual activities based on people’s life profiles. The service users said they enjoyed the entertainment and activities that were on offer. The home’s AQAA said that the manager wants to improve the activities by employing an activities co-ordinator for an additional three days a week, and by training staff to be able to offer more specialised exercises and reminiscence. The manager said there were activities available every day if people chose to participate. Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 14 During the moving in process, the service users or their relatives are asked about their preferred routines and about any hobbies or interests. The service users are then offered the opportunity to take part in activities that suit them. An example of this is one service user who was interested in railways so they were offered books on the subject and they were given staff support to make a scrapbook about the railway. The care plans include details about people’s religious preferences and church services are available in the home. The notice board displayed dates for residents meetings and the minutes showed that 31 service users attended the last meeting along with three relatives. Three visiting relatives said they were always welcome in the home and were offered drinks. They also said that the manager or staff kept them informed about their family members. During lunchtime we saw that particular care was taken to make sure that people could choose what food they would like and they were offered assistance if it was needed. The staff had a good understanding of each persons likes and dislikes so people were offered the portion sizes they preferred and were offered alternatives to the main meal. The staff were using very gentle, appropriate physical touches to reassure people and to encourage them, and people were given as much time as they needed to eat their meals. There was generally a very calm atmosphere during lunch, apart from the incidents that are mentioned in the previous section, which will be addressed by the manager. Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. Service users are confident that their complaints will be taken seriously and responded to. The service users are protected by a robust abuse procedure and through staff training. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service users and their relatives have access to the complaints procedure because it is displayed around the home. The service users and their relatives said they would feel confident to complain to the manager. No new complaints had been received since the last inspection. Staff were able to describe how they would deal with complaints and the manager said they work hard to ‘get things right, from people first being admitted’. The AQAA states that there are open meetings every six weeks for the residents and their relatives, and the complaints procedure could be supplied in audio form if needed. Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 16 During the monthly visits by the provider, time is spent talking to the service users and their relatives and this gives another opportunity for people to raise any matters of concern. The staff team have all been trained in abuse awareness and new staff are also trained. The home is owned and run by Hampshire County Council who have robust procedures for dealing with any suspicions or allegations of abuse. The manager states in the AQAA that they will improve the service by discussing any incidents with the staff so they understand what action has been taken, and all staff are trained to report incidents. Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. The service users live in a clean, well-maintained home that meets their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has recently been refurbished in a number of areas and the AQAA states that there are further plans for improvements over the next year. The home was clean and free from unpleasant odours. One relative said that there was sometimes an unpleasant odour upstairs but with improvements to the floor coverings these odours are temporary and dealt with effectively by cleaning staff. The sitting areas are comfortable and the service users said they liked their rooms, which have been personalised with their own belongings. The rooms have improved signage, which assists people finding their way around. The Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 18 service users rooms had signs that included a persons name and sometimes a picture or individual decoration. The AQAA states that regular maintenance is carried out on all the equipment and a contract makes sure the home is maintained externally and internally. Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 . Quality in this outcome area is good. A safely recruited and trained staff team supports the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is responsible for making sure there are enough staff to meet peoples needs, and they are currently discussing with their manager how finances could allow more staffing hours. The manager said that it is difficult to recruit staff in the area but they have tried to improve this by training staff to be general assistants and by employing agency staff when needed. The manager recognises that as more people are admitted to the home that have dementia more staff will be needed, and they are planning for this. Most of the service users were very positive about the staff, but three service users or their relatives said that sometimes there were not enough staff. The staff spoken to said they could do their jobs, but one team member said they needed more staff. The manager intends to review the staff levels, and they showed us evidence of having tried to recruit more domestic staff. The service users were having their needs met by the current staffing levels and the staff had time to spend talking to people and organising activities. Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 20 Staff are trained to do their jobs and for personal development. The staff described the training they had in Manual handling, First aid, Dementia awareness, infection control and challenging behaviour. The manager remains committed to training the staff team and to encouraging staff to take part in National Vocational Qualifications (N.V.Q). The staff files demonstrate that staff are recruited safely because they showed that all of the checks had been carried out, before staff started to work in the home. New staff receive a full induction to help them learn about their roles. All the staff procedures are in line with the Councils and staff are asked about whether they need support to carry on their religion or to improve their language skills or whether they need additional help due to any disability. This helps the staff to feel valued and the staff spoken to said they enjoyed their job. The staff take part in regular staff meetings so they can be told about changes and have an opportunity to air their views. Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,38. Quality in this outcome area is good. The home is managed in the best interests of the service user by an effective and approachable management team. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is competent through their experience and qualifications. The staff and the service users said the manager was approachable. We found that the manager was very helpful during the inspection process and they said they were happy to make changes to improve the home and the service they offer to people. Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 22 Improvements have been made to the management structure by the appointment of a deputy manager and a night care co-ordinator. The manager spends time talking to the service users and seeking their views about the home. The AQAA states that they seek the service users views by holding regular meetings and by surveys, the results are looked at to see where improvements can be made and the results are displayed in the home. The previous report said that the home looks after the finances for some residents and that this is done accurately. The home has safe accounting procedures that it follows. The staff said they are supervised and supported to do their jobs and the records showed that supervision and yearly appraisals take place. The deputy manager said that a lot more individual supervision takes place and it would be useful if this could always be recorded. The AQAA states when (all the) maintenance checks are done and that there are regular fire drills, and a service user confirmed this. The staff are trained to deal with all the substances they use within the home and they said they had had infection control training. This was confirmed in the training records. Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 23 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 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Copper Beeches DS0000037292.V363546.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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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