Care Home: Copperdown

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What the care home does well The service has good pre-admission procedures with people visiting the home, and meeting people already living at Copperdown, prior to making a decision about moving into the home. People can stay for a meal, meet staff and view accommodation available. There is a good programme of daily activities to suit all tastes, and meet the different needs of individuals. The environment is maintained to a high standard, some bedrooms are en/suite others are adjacent to bathrooms and toilets. Bedrooms are comfortably furnished and personalised. There are good arrangements in place to meet the health care needs of people using the service. What has improved since the last inspection? The requirements of the previous report have all been dealt with. Permanent Registered Care Manager in place. All daily activities and socialisation of people using the service is recorded. New staff work surplus to the rota for two weeks. The redecoration of the physical environment is ongoing on a rolling programme to ensure high standards are maintained. What the care home could do better: Peoples risk assessments be seperated out onto individual forms as discussed with the Care Manager. A metal trolley be provided for the storage and administration of medication. Key inspection report Care homes for older people Name: Address: Copperdown 30 Church Street Rugeley Staffordshire WS15 2AH     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Kathryn Marks     Date: 0 7 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Copperdown 30 Church Street Rugeley Staffordshire WS15 2AH 01889586874 01889572600 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Stoneleigh Care Homes Ltd care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 29 The registered person may provide the following category of service only: Care Home Only (Code PC) 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 (OP) 29 Dementia over 65 years of age (DE)(E) 3 Mental Disorder over 65 years of age (MD)(E) 3 Physical Disability over 65 years of age (PD)(E) 3 Date of last inspection Brief description of the care home Copperdown is an established 29 bedded care home for elderly people. It was acquired by new owners in July 2007. The previous high standards of care are being maintained Care Homes for Older People Page 4 of 26 Over 65 3 3 29 3 0 0 0 0 Brief description of the care home and further improvements made. The home is situated in a residential area of Rugeley very close to the town centre. There are 28 single and 1 shared bedroom, most have en-suite facilities and some ensuites have showers or baths. There is a shaft lift access and staircase to all floors. There are 2 lounges and 2 dining areas, a quiet room and large smoking area. All areas are furnished to a good standard, the home is well maintained and provides good facilities for people using the service. Health care support services are available with established positive working relationships with external healthcare professionals. There are high standards of hygiene and cleanliness throughout the home. The large landscaped garden has good seating providing a pleasant outside area during the summer months. The Statement of Purpose and Service users guide has been updated. The stated fees for Copperdown are £395 non en/suite, £405 en/suite, £425 respite, per week. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This Key Inspection was carried out on Monday 7th December 2009 by one inspector, who used the National Minimum Standards for Older People as the basis for the inspection. The last Key Inspection was 6th February 2008. On arrival for this inspection the Care Manager, one senior care, four care workers, cook, housekeeping staff and handy person were on duty. The provider also joined us for part of this inspection. The Care Manager provided written information regarding staffing, staff training, menu and dietary provision that were observed to be in place at the home. We discussed with the Care Manager the arrangements for the day, to avoid disruption to people using the service, staff, and routines in the home. Care Homes for Older People Page 6 of 26 We talked to people using the service, staff, and a relative who was visiting the home. We reviewed the care records of three people using the service, and the records of the last three members of staff employed, including recruitment and training records. We discussed the food with people using the service, and observed lunch being served. Choices were available at lunchtime and identified on the menu. We also looked at the Annual Quality Assurance Assessment (AQAA) this is a self assessment tool, and had been well completed, and sent to us prior to the Key Inspection. Completion of the AQAA is a legal requirement and it enables the service to undertake a self assessment, which focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who wish to use the service have the information they need to make an informed choice about living at the home. Evidence: The AQAA we received prior to the Key Inspection told us that A full and detailed assessment is carried out on all new people using the service, prior to admission to Copperdown. We encourage prospective people to spend the day with us, enabling us to carry out a detailed assessment to ascertain that we are able to meet individual needs. Our assessment covers every aspect of care. We also cater for respite care. All people are issued with a contract after a six week trial period and a statement of their terms and conditions. We saw that the homes Statement of Purpose and Service Users Guide, that have been updated to include the new Proprietor, Care Manager, and provide detailed information for people who may wish to use the service. Care Homes for Older People Page 10 of 26 Evidence: We saw records that told us peoples relatives had visited the home prior to admission. We talked to a relative in the home who confirmed to us that they had visited Copperdown before their relative was admitted. We saw three peoples care records and examined them in detail. Peoples records contained detailed holistic information collected by the Care Manager, who carried out the assessment. We saw risk assessments in place. This means peoples needs had been assessed, risks identified, and the home was satisfied it could meet peoples needs. We received nine completed surveys from people using the service, that told us: Five people received enough information about the service, before moving into the home. Four people told us they did not know if they had received information All had received a contract of their terms and conditions We received one completed survey from the District Nursing Service that told us that: The homes assessment arrangements ensure accurate information is usually gathered The home does not provide intermediate care. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of people using the service are met, personal care is delivered in the way the individual wishes. Evidence: The AQAA we received prior to the Key Inspection told us that The service ensures each person has an individual plan of care. The care plan is produced on the basis of a thorough assessment of persons needs. All people have access to a choice of General Practitioner and other health care professionals. The AQAA also told us that all staff responsible for administering medication have been trained to do so. All people are treated as individuals, staff respect peoples rights to privacy, dignity and respect at all times. We looked at the care records of three people using the service during this inspection. We saw that records contained detailed information regarding health care, personal care, and risk assessments that are reviewed on a regular basis. Risk assessments need to be individualised to ensure action to be taken is clear. Care Homes for Older People Page 12 of 26 Evidence: We saw detailed care plans in place that provided information for staff, to ensure that they are clear about the level of support required by individuals. The care plans are reviewed and updated on a regular basis. We saw a system in place for the recording of accidents, that identifies people who are prone to accidents. We observed that medication is administered from a monitored dosage cassette system, with the exception of medication that is not compatable with the system. Medication is taken around the home on a tray. We discussed with the proprietor the provision of a metal trolley for the storage and administration of medication, the proprietor told us he will provide a trolley. We saw records that identified medication is administered by senior staff who have been trained in the administration of medication. We saw throughout this inspection courtesy being shown to individuals, with privacy and dignity being promoted. Staff were sitting talking to people with dementia ensuring that interaction was taking place. Nine people using the service returned completed surveys to us, that told us: All received the care and support they need Staff are available when they need them We received one completed survey from the District Nursing Service that told us that: Peoples social and health care needs are usually properly monitored and reviewed The service supports people to manage their medication Peoples privacy and dignity is respected and the service supports people to live their chosen lifestyle. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service make choices about their daily lifestyle, with their visitors made welcome. The food provided is of a high standard, with a varied nutritional diet being offered. Evidence: The AQAA we received prior to the Key Inspection told us that The service helps people to continue as wide a range of individual, or group, activities and interests as possible. Individuals carry on with existing hobbies, pastimes and relationships. People are encouraged to use all areas of the home, those people who wish to remain in their own rooms are able to do so. People are encouraged to personalise their own private space. The AQAA told us they follow peoples preference regarding diet and routine of daily living. We saw that a daily programme of activities is in place, both in the morning and the afternoons, this provides for the social needs of all people living at the home. A record is kept of all activities and who is involved in them. This identifies to staff where people need one to one staffing with socialisation. We observed music and movement session taking place that people were involving Care Homes for Older People Page 14 of 26 Evidence: themselves in, and observed that staff were talking to people who were not involved and needed one to one staffing. We saw staff on duty involving people with the putting up of the Christmas Decorations, individuals told us how wonderful they thought the decorations looked. We saw the menu displayed in the hallway and in the dining room with alternative choices being available. We saw the food being served to people, this was nicely presented and portions were generous. We saw that people who needed assistance to have a meal, were helped in a discreet and sensitive manner. The staff member sat down with the person, explained who they were, what they were doing and what food was on the plate. We observed throughout this visit that where people are able to make choices they do so. Where people are unable to make their own choices, informed choices are made through families and key workers. Nine people using the service returned completed surveys to us, one person told us that: I have full assistance with daily care, the girls are kind, the food is good and plenty of it One person told us Look after me very well. I only have to ask if I want something different on the menu. Help me with all my daily needs, girls very kind and always cheerful. We were told by people we talked to in their bedroms, that staff are very supportive and went out of their way to help them and do anything you ask. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make complaints and are safeguarded by the homes procedures. Evidence: The AQAA we received prior to the Key Inspection told us that The service support the concept that most complaints if dealt with early, openly and honestly, can be sorted out at local level between just the complainant and the home. The home fully adheres to standard 16 as stated in National Minimum Standards for Older People. The goals of our home are to ensure the following, service users and their representatives are aware of how to complain. A named person is responsible. We saw the home has a complaints book, no complaints have been recorded since the last inspection. A grumbles book is in place for people and their relatives to use. There have been no complaints made to the home or the commission since the new proprietors took over in July 2007. We talked to people in the home who told us that they would talk to the manager if unhappy. We looked at the records of personal allowances of three people, we observed that detailed records are mainatined, cash balanced with records and receipts. Care Homes for Older People Page 16 of 26 Evidence: We saw staff training records that identified the staff have received training in Protection and Safeguarding Vulnerable Adults. All people using the service are treated equally, and offerred the same choices. We saw on staff files that Criminal Records Bureau and Protection of Vulnerable Adults checks are carried out, and two written references are taken up prior to employment. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables people to live in a safe, clean, well-maintained and comfortable environment. Evidence: The AQAA we received prior to the Key Inspection told us that The physical environment of the home is designed for the convenience of the people using the service. Buildings and grounds are maintained in a safe condition, communal areas are homely. The service ensures that people have safe comfortable bedrooms that are clean and hygienic. We saw that the physical design and layout of the home meets the needs of the people using the service. The various communal areas are comfortable, homely and attractive, with lots of pictures, and a variety of lighting and flowers around the home. People were relaxed in their surroundings and moving freely around the home. We were invited into peoples bedrooms that were very personalised, with favourite items individuals had bought to the home with them. Bedrooms were comfortably furnished with armchairs, tables, photographs, flowers, as one lady put it its my home now. We saw good infection control practices in place, with supplies of hand gel around the Care Homes for Older People Page 18 of 26 Evidence: home. We saw staff training records that identify staff have received infection control training. Policies and procedures were in place for the control of infection. We saw that since the last key inspection the environmental health assessment rating is 5 star. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A well trained and consistent staff team support the people using the service. Evidence: The AQAA we received prior to the Key Inspection told us that The service is committed to ensure appropriate staffing levels both in numbers and skills. The service operates two rotas one for senior staff, and one for care staff, to ensure that trained staff cover all shifts. No one under the age of 21 is left in charge. All trainers are registered on a trainers programme. Extra staff are called in at peak times when necessary. Vigorous recruitment programme, manager and senior interview new staff, appropriate checks carried out prior to employment. We saw staff records of the last three people employed by the home. Records told us that staff have received appropriate pre-employment checks prior to commencing work at the home. We saw staff training records in staff files, and on the training matrix, that identified approximately 68 of staff are trained to National Vocational Training Level 2, with 6 staff having achieved Level 3. All new staff receive a Company Induction and a general induction to the home, this is followed by two weeks where they work surplus to the rota as part of induction. Care Homes for Older People Page 20 of 26 Evidence: We saw that the Care Manager deals with all pre-admission assessments, this provides consistency for the person using the service. We talked to the Care Manager and staff who told us that they felt supported by the provider and management of the home. We talked to members of staff who told us that they received regular training opportunities, and that training is scheduled into the rota. Mandatory training is recorded in staff files and identified in training matrix. We tallked to the Care Manager who told us that recruitment is via the local job centre, and word of mouth recommendations. All staff receive Criminal Records Bureau and Protection Of Vulnerable Adults checks prior to commencing employment. Two work references are obtained. Following the last key inspection, recruitment and interview is now done by the Care Manager and a senior staff member. Two completed surveys were returned to us by staff that told us that: Always given up to date information about the needs of people being supported Appropriate pre-employment checks were carried out prior to employment Induction covered what we needed to know Always feel we have enough support and knowledge to meet the needs of people living at the home Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are safeguarded by competent management systems. Evidence: The AQAA we received prior to the Key Inspection told us that The Registered Manager is qualified and that the management approach creates an open positive atmosphere. Quality assurance and quality monitoring systems are in place, with financial procedures that protect people using the service. Regular staff supervision takes place with records being maintained. The manager is experienced and qualified to National Vocational Qualification Level 4 Registered Managers Award. The manager has 19 years experience in care of the elderly, 11 years at Copperdown. She has the Assessors award D32, 33, and NEBS Introduction to Management Award. We saw good leadership was in place, and staff knew what was expected of them. The relationship between management, staff, people using the service and their visitors, Care Homes for Older People Page 22 of 26 Evidence: generated a happy homely atmosphere. We saw quality monitoring systems in place, the care manager monitors the well being of the people using the service and the practices in the home. We saw a sample of questionnaires that had been sent out to people and an analysis of the results. We saw robust systems in place for the management of peoples personal allowance, records are kept and audited on a regular basis. We looked at the finances of three people using the service, cash balanced with records mainatined. We observed safe working practices to be in place, staff records show that health and safety training has been completed, along with other mandatory training. We saw fire inspection reports, and training records that were in place and up to date. We talked to the provider, who told us that the Care Manager has the authority, to bring in extra staff to meet the needs of the people using the service if she needs to, without first referring to the provider. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 7 10 Risk assessments on peoples files need to be individualised to ensure action to be taken is clear. A metal trolley be obtained for the storage and administration of medication. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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