Care Home: Copperfields Residential Home

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What the care home does well The home ensures that residents are able to follow their preferences in regards to their lifestyles and social activities. Care plans include risk assessments to check that residents are (for example) safe to use the lift, or to go outside without supervision. Copperfields Residential Home DS0000023919.V376748.R01.S.doc Version 5.2 Pre-admission assessments are very detailed, and cover all aspects of the person’s health and wellbeing. The manager and senior care staff carry out bi-monthly reviews of individual care plans with the resident and any other relevant family members or care manager. These reviews are much more in-depth than just a quick check through, and enable the manager to ensure that residents are receiving the care and support that they want and need. Residents said that the food is always good, and they have sufficient choice. What has improved since the last inspection? The dining room has been altered and enlarged, and new dining tables and chairs have been purchased. This is a pleasant room for dining in. Other items of furniture and equipment have been purchased during the last year, such as a nursing “profiling” bed for a resident; and some new bedroom furniture. A raised bed has been made in the rear garden, so that residents can take part in gardening in the future if they wish to do so. The front door entry system has been upgraded, ensuring that all staff on duty can hear the door bell and answer it accordingly. The manager has implemented a different induction programme for new staff, and this provides a comprehensive background and all mandatory training. All staff now have all mandatory training each year. What the care home could do better: The manager has had some training in the Mental Capacity Act 2005, and training has been booked for other staff. However, this is not as yet evidenced in care plans, and where residents lack mental capacity, the documentation will need to be put in place to show how decisions are made on residents’ behalf, and who makes these decisions. Care plans include a large number of risk assessments, but some of these were not applicable to the residents’ individual planning. For example, one care plan included the risk of “wandering” for someone who does not wander; and “using cleaning materials” for a person who does not wish to help clean their own room. Some more care is needed to ensure that the risk assessments are applicable for each person.Copperfields Residential HomeDS0000023919.V376748.R01.S.doc Version 5.2 The Controlled Drugs (CD) cupboard was not fitted in accordance with the guidelines as outlined in the Misuse of Drugs Regulations 1973 (and the amendment in 2007). This must be fitted using “rawl or rag bolts”; and must be fitted to a solid wall. Recruitment procedures are well managed; but recruitment files did not contain a current photograph of the staff member (except for photocopies of passports or driving licences which can be unclear). The manager stated that the items we discussed would be addressed, starting immediately with the CD cupboard. We have therefore not given any requirements in this report. Key inspection report CARE HOMES FOR OLDER PEOPLE Copperfields Residential Home 42 Villa Road Higham Kent ME3 7BX Lead Inspector Mrs Susan Hall Key Unannounced Inspection 31st July 2009 08:45 31/07/09 DS0000023919.V376748.R01.S.do c Version 5.2 Page 1 This report is a review of the 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. 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. Copperfields Residential Home DS0000023919.V376748.R01.S.doc Version 5.2 Page 2 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 Copperfields Residential Home DS0000023919.V376748.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Copperfields Residential Home Address 42 Villa Road Higham Kent ME3 7BX 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) 01474 824122 larchwoodcourt@tiscali.co.uk Larchwood Court Ltd Miss Janet Irene Aldridge Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Copperfields Residential Home DS0000023919.V376748.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: 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 20. Date of last inspection 22nd August 2008 Brief Description of the Service: Copperfields Residential Home is privately owned, and is managed by the provider. It is situated in a pleasant residential area in the village of Higham, which is near to the towns of Gravesend and Rochester. Local shops and amenities are located within a short walking distance. The home is registered to provide residential care for up to 20 older people but is currently only taking a maximum of 17 people, as some previously shared rooms are now used as single rooms. There is one double bedroom available if there are residents who wish to share. Accommodation is on two floors, with a passenger lift providing easy access between floors. Some bedrooms have ensuite toilet facilities, and some include a shower. There is a garden to the rear of the property. As the building is an old Victorian property, the home is not ideal for wheelchair users and therefore does not accept any new wheelchair bound residents. The current fee levels are £350.00 to £400.00 per week, depending on the assessed needs of individual residents; and the room being used. Copperfields Residential Home DS0000023919.V376748.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home is assessed as having a rating of good, 2 stars. This was a key inspection, which includes assessing all the information obtained by the Commission since the previous inspection, as well as a visit to the home. Information is obtained from phone calls and letters about the service; legal notifications which the home is required to send in; any complaints or safeguarding issues in which we are involved; and an Annual Quality Assurance Assessment (AQAA) provided by the home. This is a comprehensive document which the home is required to complete each year, telling us about ongoing developments in the home, and any changes. We received the AQAA back within the specified timescale, and it was well completed. The visit to the home commenced at 08.45, and lasted until 13:45. The registered manager was on leave at this time, but a senior carer informed her of the inspection, and she chose to come into the home at approximately 10.00 a.m. She was present throughout the rest of the inspection .During the visit, we (i.e. CQC) talked with four staff apart from the manager; two relatives, a builder who was carrying out some work in the home, and five residents (some in the lounges, and some one in their own room). We also met several other residents briefly, and observed staff interaction with residents and with each other. Residents appeared content and smiling, and it was clear that some had formed their own routines and that staff were familiar with these. There is a strong emphasis on individual care. One said that she “really likes it here”; and a relative said that family members and visitors are always made welcome. The home was clean in all areas, and ongoing work was being carried out to skirting boards in the corridors where they had become scuffed by equipment. A safeguarding alert was opened in regards to the home in February 2009, and this was in relation to staffing levels and management of pressure relief. We found that both of these areas were being satisfactorily managed at this inspection. What the service does well: The home ensures that residents are able to follow their preferences in regards to their lifestyles and social activities. Care plans include risk assessments to check that residents are (for example) safe to use the lift, or to go outside without supervision. Copperfields Residential Home DS0000023919.V376748.R01.S.doc Version 5.2 Page 6 Pre-admission assessments are very detailed, and cover all aspects of the person’s health and wellbeing. The manager and senior care staff carry out bi-monthly reviews of individual care plans with the resident and any other relevant family members or care manager. These reviews are much more in-depth than just a quick check through, and enable the manager to ensure that residents are receiving the care and support that they want and need. Residents said that the food is always good, and they have sufficient choice. What has improved since the last inspection? What they could do better: The manager has had some training in the Mental Capacity Act 2005, and training has been booked for other staff. However, this is not as yet evidenced in care plans, and where residents lack mental capacity, the documentation will need to be put in place to show how decisions are made on residents’ behalf, and who makes these decisions. Care plans include a large number of risk assessments, but some of these were not applicable to the residents’ individual planning. For example, one care plan included the risk of “wandering” for someone who does not wander; and “using cleaning materials” for a person who does not wish to help clean their own room. Some more care is needed to ensure that the risk assessments are applicable for each person. Copperfields Residential Home DS0000023919.V376748.R01.S.doc Version 5.2 Page 7 The Controlled Drugs (CD) cupboard was not fitted in accordance with the guidelines as outlined in the Misuse of Drugs Regulations 1973 (and the amendment in 2007). This must be fitted using “rawl or rag bolts”; and must be fitted to a solid wall. Recruitment procedures are well managed; but recruitment files did not contain a current photograph of the staff member (except for photocopies of passports or driving licences which can be unclear). The manager stated that the items we discussed would be addressed, starting immediately with the CD cupboard. We have therefore not given any requirements in this report. 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. Copperfields Residential Home DS0000023919.V376748.R01.S.doc Version 5.2 Page 8 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 Copperfields Residential Home DS0000023919.V376748.R01.S.doc Version 5.2 Page 9 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1-5 (standard 6 is not applicable for this service). People using the 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 home provides suitable information to enable residents to make a choice about moving into the home. EVIDENCE: The statement of purpose provides good information for residents or relatives who are enquiring about the home, and includes all the required data. The home is accessible for people who need to use wheelchairs occasionally or for short distances, but is not suitable for people who are wheelchair bound, due to the design of the house, which is an extended old Victorian house. The residents’ guide is produced in large, clear print, and contains additional detailed information. Some data for the Care Quality Commission needs to be Copperfields Residential Home DS0000023919.V376748.R01.S.doc Version 5.2 Page 10 updated due to recent office changes by the Commission, and the manager said that she would attend to this. All residents have a pre-admission assessment prior to making a decision about coming into the home. These are usually carried out by the manager and a senior carer, so that one person can converse with the person and their relatives while the other one writes down the details. We viewed three preadmission assessments and they were very detailed. They include checking people’s physical health information, their orientation and self-care ability, their risk of falls, social preferences, and lifestyle choices. These include food likes and dislikes, mixing with others, and how they wish to spend their leisure time. All residents are provided with a contract which includes the terms and conditions of residency, and each party retains a signed agreement. A trial period is agreed for approximately two months, after which a review is held with the resident, and their relatives or care manager as appropriate. The manager agrees different trial periods according to how long the resident feels they will need before making a decision about staying. The terms and conditions include the fees, and explain what is included and what is not included in them. Copperfields Residential Home DS0000023919.V376748.R01.S.doc Version 5.2 Page 11 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7-11 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are confident that their health and care needs will be met. EVIDENCE: Care plans are based initially on the pre-admission assessments, and are then developed as the staff get to know the residents more fully. We viewed three care plans and found that they contain satisfactory data to enable the staff to care for the residents effectively. The manager and senior care staff review the care plans every two months with the residents and their relatives. These are very thorough reviews, and shows that the staff have good involvement with the resident and their family in discussing any changes needed with the care planning. The manager also said that if any changes occur in between reviews, care plans are altered immediately. She randomly audits care plans each month. Copperfields Residential Home DS0000023919.V376748.R01.S.doc Version 5.2 Page 12 Care plans include very detailed risk assessments, for items such as managing medication, use of walking aids, use of bed rails (if indicated), using the lift unsupervised, handling hot liquids, and road safety. There are also good risk assessments in regards to medication management, ensuring that any residents who are self medicating are able to fully understand the medication concerned and take it correctly. Each resident has a lockable facility in their room for this purpose. Some risk assessments were not applicable to the resident concerned, and this has been mentioned already in the summary. Care plans are put into place for all aspects of care, such as hygiene needs – showing if the resident prefers a bath or shower, and the amount of help they need; assistance needed with dressing and toileting; foot care, hair care and eye care; communication needs such as glasses and hearing aids; and assistance with mobility. The home currently had two residents who needed assistance to move using a mobile hoist and two care staff; all other residents were independently mobile, or needed supervision from one member of staff. The home has pressure relieving equipment available, such as some air mattresses and cushions; and additional equipment is obtained via the District Nurses if it is indicated. If residents become unwell, the staff monitor their health needs using positional change charts and fluid charts. The care staff write daily reports for day and night care, and these contained good data. Nutritional risk assessments are backed up with monitoring of monthly weights. There is good evidence of input from other health professionals such as GPs, District Nurses, chiropodist, and optician. Care plans show that residents’ emotional, cultural and religious needs are carefully considered, and their likes and dislikes in regards to social activities. Medication is mostly administered via a monitored dosage system, and is stored in a medication trolley in a locked cupboard. Stock medication is stored in the same cupboard. The home has a drugs fridge, and the temperature is recorded daily. A controlled drugs cupboard was fitted inside the medication trolley, and this does not follow the requirements for the correct fitting of controlled drugs cupboards to a solid wall, as outlined in the Misuse of Drugs Regulations 1973, and its amendment in 2007. The manager discussed this with a builder who was present in the building at the time, and agreed that the work would be carried out within the following week; so a requirement has not been given. Medication is only administered by senior care staff who have carried out appropriate training, and who have been assessed for their competency. Some of the Medication Administration Records (MAR charts) were viewed, and these were seen to be well completed. Allergies are highlighted; and any handwritten entries are checked and signed by two staff. The charts show when “as necessary” medicines have been given, and the reason why. Copperfields Residential Home DS0000023919.V376748.R01.S.doc Version 5.2 Page 13 Residents were seen to be well groomed, relaxed and cheerful, and staff were mindful of their comfort and their individual preferences. We chatted with several residents, who showed their contentment with phrases such as “everything is fine here”. Staff are careful to ensure that residents’ privacy and dignity are maintained. Care plans demonstrate that residents are asked about their wishes in regards to death and dying, and these will be adhered to as much as possible. This may include staying in the home if they are dying, when they may not wish for hospital treatment. Staff will ensure that residents are kept comfortable, and as pain free as possible. The manager and senior staff are aware of the Mental Capacity Act, and the importance of documenting any decisions which are made on behalf of residents who lack mental capacity. This documentation is not yet in place, but is being discussed with staff. Copperfields Residential Home DS0000023919.V376748.R01.S.doc Version 5.2 Page 14 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are enabled to follow their own lifestyles. The home provides a suitable variety of activities and entertainment. EVIDENCE: The home’s care plans include a detailed assessment of residents’ social, emotional, cultural and religious needs, ensuring that residents are treated as individuals, and encouraged to retain their own hobbies and pursuits. Weekly activities recorded in one care plan included flower arranging, board games, card games, bingo, quizzes, knitting, nail care and singalongs. The care staff are responsible for carrying out activities on a day to day basis, and during the visit, a number of residents in the lounge enjoyed singing together – assisted by one of the care staff. A lady comes in on Mondays to offer massage (e.g. hands, feet, neck), and on Tuesdays the hairdresser visits. There are “motivation” classes every two weeks, and these include items such as reminiscence, word games, and musical items. Daily newspapers are delivered Copperfields Residential Home DS0000023919.V376748.R01.S.doc Version 5.2 Page 15 as wished, and residents can choose whether they wish to stay in their own rooms or mix with others. The care staff spend time with residents on a one to one basis if they do not wish to mix, or if they are confined to their rooms for any reason. The bi-monthly reviews are used as an opportunity to find out if there are any additional activities that residents would like, and these are included in their care plans. Special birthdays are celebrated with a jazz band, and a party and all staff, relatives, and friends of the client are invited. On other birthdays, residents are given a gift and a birthday cake. Residents have the opportunity to go out in the garden, and a raised gardening bed has been put in place in the last year, so that residents who wish to can take part in gardening. The home has a minibus enabling residents to be taken out for drives or to pubs, shops etc.; and several enjoy going out with their families. We talked with two relatives, who said that the residents to whom they were related were happy in the home, and they had no problems with the care given. Relatives said that they are always made welcome in the home. Residents are able to help choose the décor for their rooms when they move in, and are consulted about the décor for communal areas when redecoration is taking place. Bedrooms were seen to be different according to personal taste, and some included items of residents’ own furniture as well as pictures, ornaments etc. Residents can have their meals in their own rooms or in the dining room. Tables are attractively laid with colour co-ordinated cloths and napkins, and have fresh flowers. There is a four weekly menu plan, and it includes a meat, fish and vegetable choice each day. The cook ensures that special diets such as diabetics are catered for; and meals are liquidised for residents if necessary. The kitchen is well equipped, and was seen to be clean and in good order. Copperfields Residential Home DS0000023919.V376748.R01.S.doc Version 5.2 Page 16 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents know that any concerns or complaints are taken seriously, and will be addressed appropriately. EVIDENCE: The complaints procedure is on display in the entrance hall and is included in the residents’ guide. People who wish to complain are encouraged to speak to the senior carer on duty in the first instance, or to ask to speak with the manager. The procedure states that “however seemingly unimportant” a concern or complaint may be, it will always be taken seriously. All complaints are investigated and responded to within twenty-eight days. The home had one complaint during the past year, and the documentation showed that this had been dealt with appropriately. The manager and senior staff are aware of the protocols for referrals to the Social Services Safeguarding Team if needed. A Safeguarding alert was opened in February 2009, and the home co-operated throughout with the investigation. All staff are trained in the recognition and prevention of adult abuse, and have updates with this training every year. Copperfields Residential Home DS0000023919.V376748.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19–22, and 24-26 People using the 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 premises provide a comfortable and well maintained home for the residents. EVIDENCE: The premises are an extended and altered original Victorian building, and provide a homely and comfortable atmosphere for residents. A new door entry system has been fitted in the last few months, enabling all staff to hear the front door bell and respond to it. There is parking for several cars at the front; and a ramp leading to the front door. The main lounge overlooks the rear garden, and there is a small quiet lounge adjoining it, which overlooks the front. These have had new armchairs and Copperfields Residential Home DS0000023919.V376748.R01.S.doc Version 5.2 Page 18 new carpeting during the past year. The dining room has been altered to make it larger, and new dining tables and chairs have been purchased. The home has a passenger lift from the lower ground floor to the first floor. Bedrooms are situated on the ground and first floors, so there is access via the lift. The kitchen and laundry are situated on the lower ground floor; and there are staff facilities and the manager’s office on the second floor. There is an ongoing programme of redecoration as needed, and the house and gardens were seen to be well maintained. The carpets are treated with a professional deep cleaning process every six months, or more frequently where needed. A builder was currently working on replacing scuffed wooden skirting boards with new plastic ones, which will withstand being knocked by various items of equipment. Bedrooms were seen to be personalised according to choice. A new “profiling” bed has been purchased for one resident during the last year, in order for the resident to be more comfortable; and to assist staff with moving and handling. The home has two hoists available, one on each floor, and residents have their own individual slings for hoisting. There were currently two residents who needed assistance with the use of a hoist. The home has an assisted bath and an assisted shower; and some bedrooms have en-suite toilet facilities. The home employs a part-time handyman, and he carries out weekly checks such as fire alarm test, wheelchair checks, hot water temperature checks, and window restrictor checks. We viewed some of these records, and they were well maintained and up to date. The home has a laundry room which is fitted with one washing machine and one tumble dryer. Care staff are responsible for carrying out the laundry. There is also a hairdressing room with a backwash sink on the lower ground floor. Copperfields Residential Home DS0000023919.V376748.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27-30 People using the 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 home maintains satisfactory staffing levels, which are assessed according to the dependency levels of residents. Staff recruitment and training programmes are well managed. EVIDENCE: The home’s manager is usually on duty during the week, as well as a senior carer for each day shift and two other carers until 5pm. There are two staff from 5-9.30pm and two staff available at night. One of these is a waking carer, and the other sleeping. The manager said that these numbers are usually sufficient, but she would make other staff available if a resident was particularly unwell or needed more attention for a specific reason. The home only takes up to seventeen residents, although the registration is higher. This is because some rooms have been altered, so that there are now fifteen single rooms and one shared. This room is being used as a single room at present, so the maximum number of residents is currently sixteen. At the time of the inspection, the majority of residents were self caring, or needed minimal assistance with personal care. This provides sufficient time for the care staff to take part in activities, and to take residents out on a one to one basis as well. Most residents currently preferred to go to bed before 9.30pm, and although Copperfields Residential Home DS0000023919.V376748.R01.S.doc Version 5.2 Page 20 two needed two staff to assist them with hoisting, this is not a long process, so that one carer can quickly return to oversee the care of other residents. The home also has a cook on duty and a cleaner on most days, although on the day of the inspection there was no one to cover for a cleaner who was on annual leave. However, the care staff said that they were able to keep the premises clean until her return; and they usually manage the cleaning when she is off duty. The manager needs to ensure on an ongoing basis that there are sufficient numbers of cleaning staff employed so that care staff can concentrate on giving care. The home has a contract with an agency to provide care staff to cover for annual leave or sickness if needed. The manager stated that all care staff are studying for NVQ levels 2 or 3, although the current number who had qualified was four out of nine care staff. The percentage is therefore below fifty per cent, but this will improve when other care staff have completed training. Senior carers have completed NVQ level 3, and are also supported with studying for NVQ level 4 if they wish to do this. The home has good recruitment procedures in place, ensuring that the required checks are made. These include POVA first and Criminal Record Bureau (CRB) checks; a criminal declaration; three written references (in place of the required two); a health questionnaire; a complete employment history; and proof of identity. However, there were no staff photographs on record, only copies of passports or driving licences which are not clear enough records. The manager said that she would implement this immediately, so a requirement has not been given. Applicants are interviewed by the manager and another staff member; and successful applicants are given a job description and a contract. The manager employs a part time trainer, who oversees all inductions and mandatory training. The induction programme is comprehensive, and care staff are required to show their competency in different areas before progressing to new topics. All staff complete all mandatory training each year, e.g. moving and handling, basic food hygiene, fire awareness and health and safety. A training matrix confirmed that this training was being carried out. One of the care staff said that the “induction was very detailed, and very helpful”. Copperfields Residential Home DS0000023919.V376748.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31-33; and 35-38 People using the 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 manager is qualified and competent; and ensures the health and welfare of residents and staff. EVIDENCE: The manager has fifteen years of experience in care, and has completed the Registered Managers’ Award. She keeps her own skills updated, and was currently attending training in the Mental Capacity Act, and how to apply this for residents in the home. She has already prepared some documentation to implement this, but does not wish to commence it until sufficient numbers of staff have received and understood the training. Staff have a good working Copperfields Residential Home DS0000023919.V376748.R01.S.doc Version 5.2 Page 22 relationship with the manager, and are able to discuss any ideas or concerns as they arise. The home has a staff meeting each month except for August, when more staff are taking annual leave. The home does not have formal residents meetings any more, as the manager and residents have found that it is more effective to ask residents for their individual feedback every two months at their bi-monthly care plan reviews. The manager has a daily presence in the home, and obtains feedback every day. She also provides questionnaires every year, and the results of these are collated, and form the basis for changes to be made. Residents can have small amounts of personal money stored in the home on their behalf, and these are kept in individual amounts, and all records and receipts are retained. Each debit is signed by two people, and audits are carried out to check the amounts. Staff have formal one to one supervision sessions every two months, and have practical sessions when they are observed for their competency. This ensures that they understand their training, and also helps to build up their confidence. Policies and procedures are reviewed every year, and are kept up to date and accessible to the staff. Records were generally seen to be satisfactorily maintained; and are stored to retain residents’ confidentiality. The manager ensures that health and safety checks are comprehensive, and individual risk assessments show that this is taken seriously. Residents are assessed for separate items such as if they wish to tidy their own rooms, or go out unsupervised. Cleaning chemicals are kept locked when not in use. Accidents are recorded appropriately, and are followed up to see if any further prevention could be put in place. Copperfields Residential Home DS0000023919.V376748.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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 Copperfields Residential Home DS0000023919.V376748.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 Copperfields Residential Home DS0000023919.V376748.R01.S.doc Version 5.2 Page 25 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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