Care Home: Coppice Lea

Similar services:

• The Shelley
• Thorndene
• Springfield House
• Sutton Lodge Nursing Home
• St Helier`s Residential Hotel
• St Joseph`s
• Ridgemount
• Wingham Court

What the care home does well The home offers an attractive environment, welcoming and friendly atmosphere and the management and administration is good. A survey respondent states.....Staff are friendly, pleased to see you and the manager always helpful and cooperative. The home`s pre admission assessment procedures and good multi disciplinary working ensures that individual`s needs are appropriately identified and met. A health professional surveyed states....Caring and professional in all respects. Another social work professional records.....General standard of care offered is good and multi disciplinary working is effective. Staff have a good rapport with service user`s relatives and representatives. A relative of a service user states.....What I like is that there are qualified nurses on duty at all times. Housekeeping is unobtrusive and efficient. Staff appear welcoming and cheerful and there are no restrictions on visiting. There are also regular meetings to keep us updated and I know the food is good too! Surveys evidenced particularly high levels of praise in relation to the work of the home`s activity organiser. A respondent says.....The events organiser is wonderful and does much to make residents happy. Another respondent states......Excellent and varied programme of activities offered. And.....Excellent activities organiser who knows residents well and always tries to meet their needs. What has improved since the last inspection? Three staff files were sampled on this visit and evidenced all the necessary documentation to satisfy the demands of legislation and good practise. A requirement issued at the last inspection to improve recruitment procedures in the home and make them more robust to better protect service users has been addressed and has been removed from this report. Environmental shortfalls detailed in the last inspection report have all been addressed to ensure that service users live in a safe, well - maintained environment. What the care home could do better: The home`s information documents require a minor review and update to ensure people accessing the service have all the information they need prior to moving in and later for reference. An improvement to care records and care documentation would better evidence the home`s good practise and how service user`s needs are being met. Strategies should be considered for improving communication between all staff members to effectively demonstrate a thorough understanding of the particular needs of individuals and to consistently deliver highly effective person centred care. Key inspection report Care homes for older people Name: Address: Coppice Lea 151 Bletchingley Road Merstham Surrey RH1 3QN     The quality rating for this care home is:   two star good 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: Marion Weller     Date: 0 5 0 1 2 0 1 0 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 30 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 30 Information about the care home Name of care home: Address: Coppice Lea 151 Bletchingley Road Merstham Surrey RH1 3QN 01737645117 01737642767 coppicelea@caringhomes.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Coppice Lea (Merstham) Ltd Name of registered manager (if applicable) Mrs Janet Susan Varndell Type of registration: Number of places registered: care home 53 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 53. The registered person may provide the following category of service only: Care home with nursing (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Dementia (DE) Physical disability (PD) Date of last inspection Brief description of the care home Coppice Lea is a care home that provides personal care and nursing and is registered for a maximum of 53 older people. The service offers permanent, short stay and respite care. Coppice Lea is a substantial Victorian detached property which has been further extended and refurbished over the years. Service user bedroom Care Homes for Older People Page 4 of 30 53 0 53 Over 65 0 53 0 Brief description of the care home accommodation is arranged over three floors, accessible by passenger lift. All bedrooms have en-suite facilities and all but one is for single occupancy. There are attractive and comfortable communal areas and pleasant gardens provide opportunities for outdoor recreation in fine weather. Coppice Lea is in a semi-rural location, set in five acres of attractive landscaped and wooded grounds. The home is located on the outskirts of the villages of Merstham and Bletchingly and is convenient for access to and from the M25 and both Reigate and Redhill town centres. The weekly fees charged by the home range from £550 to £850 per week for personal care only and from £550 to £1200 per week for nursing care. Fees are fully inclusive, except for some social extras such as hairdressing and newspapers. Please speak with the Registered Manager for more detailed information. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Coppice Lea last had a key inspection on the 13th March 2008. Two Statutory Requirements were awarded as a result of the site visit. The home was subsequently assessed as a two star - good service. An Annual Service Review (ASR) was completed on the 13th March 2009. As a result of the service review, no changes were felt to be necessary to our scheduled inspection programme. The inspector, who was unaccompanied during this key inspection visit, arrived at the service on the 5th January 2010 at 10:45 am and was in the home for five and a quarter hours. During the site visit the inspector spoke with some service users and their relatives, two of the nursing staff, the homes housekeeper and the laundry assistant, the activity coordinator and an administrative assistant. The inspector also spoke at length with the registered manager and the operations manager, who is also registered as the responsible individual for the service. A number of documents relating to service users were sampled including three care plans, risk assessments and Care Homes for Older People Page 6 of 30 medication administration records were also seen. Three staff files, including recruitment and training records were checked. The inspection report takes into account all the information obtained about the service. This includes any formal notifications, reports, phone calls and letters received and any information concerning complaints or allegations. The manager was asked to complete the homes Annual Quality Assurance Assessment (AQAA) prior to the inspection. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gives some numerical information about the service. The completed document gave us information that provided a reasonable picture of what was happening in the service and their plans for further development. Surveys were sent out by the CQC to ask for peoples views about Coppice Lea. 22 responses were received back and used to inform our opinion about service outcomes. Comments taken from surveys have been used throughout the report. The inspector looked at how well the service was meeting the standards set by government and has in this report made a judgement about the standard of service provided by the agency. There were no legal requirements made as a result of this inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: The homes information documents require a minor review and update to ensure people accessing the service have all the information they need prior to moving in and later for reference. An improvement to care records and care documentation would better evidence the homes good practise and how service users needs are being met. Strategies should be considered for improving communication between all staff members to effectively demonstrate a thorough understanding of the particular needs of individuals and to consistently deliver highly effective person centred care. Care Homes for Older People Page 8 of 30 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 9 of 30 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 10 of 30 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. Prospective service users can be confident that their needs would be comprehensively assessed prior to a place at the home being offered. The homes information documents require a minor review and update to ensure people accessing the service have all the information they need prior to moving in and later for reference. Evidence: The home clearly understands the importance of people having sufficient information when choosing a care home. The Annual Quality Assurance Assessment (AQAA) sent to us by the manager records.....We make available to all prospective service users our Statement of Purpose and Service User Guide and a copy of each are kept in reception. The inspector requested a copy of the homes Statement of Purpose and Service User Guide during the site visit. Both documents were received electronically the day after the inspection. When viewed, Page 11 of the Statement of Purpose dated 21/01/2009 records both the current and the previous name of the Regulator. This Care Homes for Older People Page 11 of 30 Evidence: could cause confusion for people wanting to access help or advice from the regulatory body, The Care Quality Commission. The Care Quality Commission is the independent regulator of all health and adult social care in England. The providers website gives information about Coppice Lea to those with access to the internet and also refers to the previous regulators title. It is therfore recommended that information provided to service users and their representatives is reviewed and updated, to avoid any potential for confusion. The registered manager or a medically trained member of staff visits prospective residents prior to admission to make a decision as to whether the home can meet the persons needs. Information is obtained from other parties, including relevant health care and social care professionals to assist in assessment decisions. Two pre admission assessments were inspected and found to be detailed and comprehensive. The manager said they encourage prospective residents and their relatives or representatives to visit the home prior to any firm decision being made to move in. Survey respondents spoke of being welcomed to the home and how they or their relatives were assisted to settle in. One respondent records......Our relative has settled in well and is more content than they have been for a long time. Another respondent states.....Coppice Lea have made great efforts to help our relative settle in and have been very kind and tolerant. Staff evidenced they had the clinical knowledge and practical skills to care for individuals admitted to the home and were observed to be very hard working. Intermediate Care is not provided at Coppice Lea Care Home. Care Homes for Older People Page 12 of 30 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. Residents care and health needs are being met in a dignified and appropriate manner. An improvement to care records would better evidence how they are being met. Evidence: Three service user care plans were inspected on this site visit. Care plans are designed to cover the health, personal, emotional and social care needs of service users. In addition, preferences and general likes and dislikes of individuals were being recorded to ensure that staff knew how the person wished to be cared for. The manager records that service users and their relatives or representatives are encouraged to be involved in the initial assessment of need, care plan development and risk assessment and review process. The home is in the process of updating their current care plan format and has introduced some new templates. The manager has awareness that some areas of the individual plans of care require further development and improvement to better evidence the homes good practise. Some minor shortfalls were highlighted and discussed during the site visit. The manager records in her AQAA what they could do better in this outcome area.....The completion of documentation to ensure it states individualised care. Staff have had training and this is ongoing to ensure they know Care Homes for Older People Page 13 of 30 Evidence: the correct way of completing the new documentation introduced. The manager further records that plans are in place to continue training staff over the next 12 months in the effective use of care documentation. Service user daily records are being maintained. The amount of detail in some records was found to be inconsistent and dependent on the skill of the staff member completing the record. Daily records when well written help senior staff to audit the care provided and ensure that staff follow the guidelines in the plan of care. It is in the homes interests to be able to illustrate what they have done for the individual and provides evidence on which to base reviews and to record that they are following the assessment of a service users needs. Risk assessments are in place for a variety of aspects of care. Attention has been paid to prevention of falls and the moving and handling needs of residents. Health needs are responded to quickly and records indicate that advice is sought from other health care professionals when needed. Pressure relieving equipment was in evidence in the home. Treatment plans for pressure areas were also seen and tissue viability nurses visit the home and provide advice and direction when required. The home is equally supported in providing End of Life Care by clinical nurse specialists from a nearby hospice. The manager has plans to further improve the education in palliative care issues for all senior and trained staff employed. Survey respondents were overall very positive about the standard of care provided at Coppice Lea and said staff are hard working, kind and patient. A number of respondents however raised concerns about cultural and language barriers between service users and some staff that occassiongly impacts on the care provided. A respondent records.....I feel that because of cultural and language difficulties staff dont always grasp what I am saying to them. Another records, when asked what the home could do better? ......Communication could be improved, they need more English speaking people. The manager confirmed her awareness of the issue and said that staff whose first language is not English are encouraged and supported by the provider organisation to attend improving English courses at a local college. In addition, the management team look closely at this aspect during staff recruitment to ensure they employ people who can communicate effectively with service users to ensure their needs were being consistently met. Only Registered Nurses administer medication to service users. Medication Administration Records (MAR) showed generally safe practice. One shortfall was discussed with the nurse on duty and the manager. MAR charts did not evidence that all topical medicines prescribed are being signed for. The manager stated her firm Care Homes for Older People Page 14 of 30 Evidence: intention to resolve the recording omission to evidence good practice and to ensure all medication records are made available should it be necessary to formally audit medication administered to a service user. Residents with proven capacity are able to manage their own medication and this is agreed through a clear risk assessment process. Medication is stored securely within the home. There was clear evidence that service users privacy and dignity is respected. Staff were observed to knock on bedroom doors, called residents by their preferred names and provided personal care in the privacy of peoples bedrooms and bathrooms. Service users confirmed in conversation that staff treat them in a respectful manner. A survey respondent recorded.....I am always treated with care and respect. Care Homes for Older People Page 15 of 30 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. Service users find the lifestyle in the home matches their expectations. The availability of additional resources would help them fully satisfy their leisure and recreational needs. People living at the home are able to maintain bonds with family and friends and they receive a wholesome, appealing and balanced diet in very pleasant and attractive surroundings. Evidence: Service users are involved in meaningful day time activities of their choice and according to their individual interests, needs and capabilities. To this end the home employs an activity coordinator who organises regular activity sessions for service users. Lists of the activities and special events are displayed in the home and include bingo, hand / eye co-ordination activities, quizzes, outings, exercise sessions, music appreciation and carpet boules. Service users spoken with praised the efforts of the activity Organiser. Survey respondents also spoke highly of the person in post. Respondents said.....Excellent activities organiser who knows the residents well and tries so hard to meet everyones needs... Another person records....The events organiser is wonderful and does so much to make residents happy. She is easy to talk to and the events put on at regular intervals are always marvelous. And.....Wonderful Care Homes for Older People Page 16 of 30 Evidence: person...but badly needs extra help. The activity co coordinator said that the home has shared access to a mini-bus which is used to transport residents out in the community and they visit garden centres and local attractions, including pubs and theatres. External entertainers also visit the home. From discussion with service users and staff barriers to further improvement in the programme of activity at Coppice Lea is only limited by the availability of additional resources such as the consistent availability a second person to support and the co-ordinator in her role. There are opportunities for service users from diverse religions to meet their religious and spiritual needs and the manager said that staff will make individual arrangements where necessary. Service Users are encouraged to personalise their rooms. Some people living at Coppice Lea had brought small items of furniture and personal effects with them. As rooms are of various shapes and sizes this leads to very individual environments. One service user spoken with said......this is my now my home and I am very happy to be here. Family and friends are welcome to visit at any reasonable time. Relatives spoken with confirmed that they are made to feel welcome and included by staff and encouraged to visit regularly. Visitors are offered refreshments and take meals with their relatives living in the home if they wish. People living in the home were complimentary about the food provided. The dining room is very well decorated and maintained and provides a welcoming and attractive environment, with tables laid with tablecloths and napkins and peole can enjoy a really beautiful view of the surrounding grounds from their seats. Adapted equipment is available for those people with special needs who wish to maintain their independence and staff are available to sensitively offer help to those who need it. The AQAA records.....Service Users receive a varied, wholesome and nutritious diet which is suited to individual assessed needs. Meals are taken in the dining room or in peoples own rooms if requested. Each service user is offered three meals a day which includes a full English breakfast, lunch and dinner which includes a starter, main course and a desert plus snacks throughout the day. Special diets are available. Menus are changed regularly with the input of the service users. We have a meet the chef meeting monthly where our service users and their families can discuss the menu and the serving of meals, as well as discussions on a daily basis with the chef and the home manager. A daily menu is displayed in a display case outside the dining room, as well as on the dining tables. Care Homes for Older People Page 17 of 30 Evidence: Regular residents / relatives meetings are being held with notes of meetings made available to people who live in the home. The manager also spoke of setting up a relatives committee to help and advise on further service developments and initiatives in the home. Care Homes for Older People Page 18 of 30 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. There are systems in place to ensue that service users are protected from abuse and they can be confident that their concerns and complaints will be acted upon. Evidence: The home has strategies in place to ensure that those who live there and those that visit can make their views and complaints known. Survey respondents generally said they felt confident about raising concerns with the service and knew they would be listened to and any necessary action would be taken. One survey respondent records....I have found that if you have concerns and voice them to the right people, things do change for the better. The registered manager has a heightened awareness that the quality of the service provided is the responsibility of the provider and all concerns and complaints should be raised with the home in the first instance. The home keeps a record of all complaints received by them with clear outcomes. All complaints received had been investigated and responded to within the timescale given in the homes complaints procedure of 28 days. There are procedures for responding to suspicion or evidence of abuse and neglect to ensure the safety and protection of service users. The staff induction and NVQ training in place has elements of adult protection and there has been Safeguarding Adults training for staff in the last year. Safeguarding adults training is ongoing and more Care Homes for Older People Page 19 of 30 Evidence: update training is planned for 2010/11. In addition, the homes AQAA records how they have further developed training over the last 12 months....Staff are given training in safe guarding adults as well as the Mental Capacity Act and Deprivation of Liberty Safeguards. This is ongoing and training completed by senior staff will be cascaded to everyone. Staff spoken with had a good understanding of adult safeguarding and protection procedures. The manager stated that any allegation of abuse would be referred to the concerned agencies without delay. A safeguarding alert and subsequent investigation concerning Coppice Lea that the CQC received information about over the last 12 months, is now closed. The home has no outstanding actions to take. POVA First and Criminal Record Bureau checks have been obtained for all staff. The registered manager is aware of her obligations with regard to ensuring the safety of residents and protecting them from all forms of abuse. Care Homes for Older People Page 20 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users live in a very attractive, well-maintained and safe environment that meets their expectations. Evidence: The home provides accommodation for up to a maximum of 53 older people. All service users bedrooms have en-suite facilities and are offered for single occupancy. There are very attractive and comfortable communal areas for people to enjoy and pleasant gardens which provide opportunities for outdoor recreation in fine weather. Windows are double glazed and fitted with window restrictors where necessary throughout. Bedrooms have space to display personal possessions, store clothing, sit and relax and have a comfortable bed. Aids and adaptations are provided where necessary such as lifting hoists, specialist baths, height adjustable beds, pressure relieving equipment, grab rails and toilet riser seats. A staff call system is available to service users. Residents are protected from the risks of burns or scalds by protected radiators and thermostatically controlled hot water outlets. The homes maintenance staff test water temperatures regularly and results are recorded and monitored. Evidence was seen that all environmental shortfalls detailed in the last inspection report have been addressed since the last visit. The statutory requirement will Care Homes for Older People Page 21 of 30 Evidence: therefore be removed from this report. The managers AQAA records that.....A programme of routine maintenance and renewal is in place. We tour the building on a regular basis to ensure standards are met and any problems rectified. The grounds are kept safe and tidy by a contract gardener who visits on a weekly basis to ensure high standards are met. We have had a Fire Officer and Environmental Health Officer visit and an external Health and Safety inspection this year. The manager stated that no issues identified remain outstanding from the three officers visits. The home has a dedicated hair salon, treatment room, sluice facilities and laundry room. Service users have unrestricted access to all communal areas of the home except for access to the assisted communal bathrooms which the manager said are kept locked for reasons of safety. The manager spoke of her intention to evidence the reason for the restriction to people living in the home by formulating environmental risk assessments for inspection purposes. Communal toilets and bathrooms are supplied with liquid soap, sanitiser gel and paper towels. Infection control measures are clearly in place and staff receive training in hygiene and control of infection. On the day of the site visit the home was clean, tidy and free from any offensive odours. Service users said they liked their rooms and the home met their expectations. No survey respondents raised any concerns about the homes environment. One survey respondent said however when asked how the home could improve.....They need more disability equipment. The author does not however detail what items are specifically needed. No shortfalls were observed or became apparent from the documents seen during this site visit. Care Homes for Older People Page 22 of 30 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 motivated staff team are provided in sufficient numbers to support and meet the assessed needs of the people currently living in the home. The recruitment procedure for new staff evidences improvement since the last inspection and now better protects service users from any potential for harm. Strategies should be considered for improving communication between all staff members to effectively demonstrate a thorough understanding of the particular needs of individuals and to consistently deliver highly effective person centred care. Evidence: Staffing numbers on the day of the inspection were observed to meet the needs of the people living in the home. It was evident that the home employs a multi-cultural workforce and equality and diversity issues are being addressed, both for the people living in the home and within the staff group. Survey respondents and service users spoken with were overall very positive about the standard of care staff provide at Coppice Lea and said they were very hard working, kind and patient. A number of survey respondents however raised some concerns about cultural and language barriers between service users and staff, which sometimes impacted negatively on the care provided. The manager confirmed her Care Homes for Older People Page 23 of 30 Evidence: awareness of this issue and said that staff whose first language is not English are encouraged and supported by the provider organisation to attend improving English courses at a local college. In addition, the management team looked closely at this aspect during recruitment to ensure staff offered employment had the ability to communicate effectively with all service users. Maintaining consistent and effective communication between staff to the benefit of service users was also raised as an area for further improvement in surveys sent to the CQC. For example, a health professional surveyed records.....they could improve the co-ordination of information about service users between various levels of staff. Another respondent states....I think communication could be better. Strategies are in place for dealing with my relative, but not all staff carry them out. Some staff say they are not even aware of them when I ask. This is an area in which the home could really do better. A third respondent says.....Staff are great but improved communication between individuals and different shifts is necessary. Its important that staff understand and remember things that have been agreed. The manager spoke of her firm intention to introduce strategies over the next year for improving communication in the home. The home has well maintained training records which provide a clear overview of staff training completed, training planned and when training updates are due for staff. There is a comprehensive induction programme for new staff, which meets the standards required by Skills for Care. Mandatory training for staff is up to date with more up date training planned. The home follows the provider organisations recruitment policy and procedure. Three staff files were sampled on this visit. CRB and POVA checks were clearly in evidence and all files contained the necessary documentation to fully satisfy the demands of legislation and good practice. A requirement issued at the last inspection to improve recruitment procedures and make them more robust to better protect service users has been removed from this report. Care Homes for Older People Page 24 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receiving services benefit from a qualified and competent manager whose aim is to consistently improve and develop service outcomes for people who live in the home. Evidence: The homes new manager, Mrs Janet Varndell transferred to Coppice Lea from another of the provider organisations establishments in November 2008 and applied for registration with the CQC, completing the fit person process in June 2009. Mrs Varndell evidenced that she had the relevant experience and qualifications to support her application. Mrs Varndell is a qualified registered nurse (RN) with a number of years experience of managing older peoples services in both residential and nursing home settings. In addition, Mrs Varndell holds the Registered Managers Award and regularly undertakes developmental and update training in regard to the management of the home. Mrs Varndell states that she has an open door policy and staff spoken with said they find her approachable and supportive. Survey respondents also Care Homes for Older People Page 25 of 30 Evidence: recorded positive comments about her co-operative and helpful style. Two respondents said that although they did not doubt the managers organisational and management skills, they would like her to be more visible and involved operationally in the home, to reinforce a more individual and person centred approach. The home has a well developed policy on quality assurance and uses annual surveys to obtain feedback from all stakeholders in the service. Regular staff, residents and relatives meetings are held and a relatives committee is due to be set up with the intention of this process informing future service developments and the homes business plan. A representative of the provider organisation undertakes regular Regulation 26 visits. Detailed and comprehensive records of these visits and actions taken as a result, to secure the welfare of service users, are available in the home to see. The manager understands the principles of equal opportunity and diversity and applies the concept to her practice with service users and staff. She was able to evidence accountability and commitment to ensuring the health, welfare and safety of the people living and working at Coppice Lea. There are records of fire systems checks and fire drills / training. The AQAA records maintenance and safety checks are up to date. On the day of the site visit the home electrical installation was receiving its five year safety check. All records seen are kept in a manner that preserves confidentiality. General record keeping is good and well ordered. The manager is supported in her role by administrative staff. The home also assists some service users with the day- to- day management of their monies. Records are kept of transactions with receipts held detailing any expenditure made on peoples behalf. These are checked by the organisation as part of their normal audit process. Some records and balances were also checked during this visit and all were found to be correct. The manager completed the homes Annual Quality Assurance Assessment (AQAA) when we asked for it and within the timescale given. The document provided a reasonably good picture of what had been happening in the home since the last inspection but some of the outcome areas could have included more detailed information and some of the data section was incomplete. The home manager and the operations manager were able however to provide a detailed explanation of any shortfalls in the document during the site visit. Discussions took place about improving content for future assessments to better evidence the homes good practice and its further development. Care Homes for Older People Page 26 of 30 Evidence: Care Homes for Older People Page 27 of 30 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 28 of 30 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 Care Homes for Older People Page 29 of 30 Helpline: 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. 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. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!