Care Home: Coppice Lodge

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What the care home does well People are given information about the home, and the chance to visit before they come to live at Coppice Lodge.People say they are happy living at the home.People living in the home are able to enjoy an active lifestyle with lots of choices of things they can do.People who live at Coppice Lodge are supported to keep in touch with their families and friends.People can choose what they want to eat from the healthy menu that is available.Coppice Lodge looks after people well and writes down what help everyone needs.People are supported in their medical appointments.Staff training and development is encouraged by the manager to make sure that people who live at the home receive the best possible service.Coppice Lodge makes sure that all staff are trained to give medication safely.Staff make sure that the care provided is flexible, consistent and is able to meet the changing needs of individuals.Coppice Lodge makes sure that suitable staff are employed and that all checks are made to keep people safe.The manager has the skills and experience to make sure the home is well run. The management team supports staff. What has improved since the last inspection? More staff have trained to develop their skills and become qualified to give support to people who live at Coppice Lodge.Redecorating the communal areas of the house is due to start. What the care home could do better: A record should be kept when medication is not given. This makes sure that there is a record to say why it was not given.A photograph for each person who takes medication should be included in the records, to make sure people are kept safe. Key inspection report Care homes for adults (18-65 years) Name: Address: Coppice Lodge 66 Walter Nash Road Kidderminster Worcestershire DY11 7BY 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: Dianne Thompson Date: 1 5 1 0 2 0 0 9 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. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 Adults (18-65 years) Page 2 of 39 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 Adults (18-65 years) Page 3 of 39 Information about the care home Name of care home: Address: Coppice Lodge 66 Walter Nash Road Kidderminster Worcestershire DY11 7BY 01562637665 01562861162 faith.fhh@blueyonder.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr. Trevor Burgess, Mrs. Faith Elizabeth Burgess care home 8 Number of places (if applicable): Under 65 Over 65 8 0 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 8 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: Learning disability (LD) 8 Date of last inspection 1 6 1 0 2 0 0 6 Care Homes for Adults (18-65 years) Page 4 of 39 A bit about the care home Coppice Lodge is owned by Mr. Trevor Burgess and Mrs. Faith Burgess. Mrs. Faith Burgess is also the registered manager. Parking is available at the front of the home. 8 people with learning disabilities live at the home. The house is close to shops and the town centre. Care Homes for Adults (18-65 years) Page 5 of 39 The home has its own vehicle so people can go on trips out. There is a bus stop near the home where people can take buses into the town centre or other places. People can use trains and taxis to go to other places and the home supports people to make these trips. Care Homes for Adults (18-65 years) Page 6 of 39 There is a TV lounge, a music room, and a separate dining room on the ground floor. Each person has their own bedroom. No-one has to share a bedroom. There is a large garden at the back of the house with a patio and seating where people who live in the home can meet up and talk to each other. Fees levels are between £780.00 to £2,500.00 per week although these may vary depending on peoples individual needs. Page 7 of 39 Care Homes for Adults (18-65 years) 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 8 of 39 How we did our inspection: This is what the inspector did when they were at the care home The inspection was carried out by one inspector who visited the home without telling anyone she was coming. This inspection was to look at what life is like for people who live at Coppice Lodge. The inspector was there on Thursday 14th October 2009. Throughout this report the term we will be used as the report is written on behalf of the Care Quality Commission. Care Homes for Adults (18-65 years) Page 9 of 39 We spoke to people living in the home. We talked to staff on duty and the manager. 6 surveys were returned from people who live in the home. 5 surveys were returned from people who work in the home and comments from 2 professional people were received. Care Homes for Adults (18-65 years) Page 10 of 39 We looked around the home. We looked at the care records of 3 people who live in the home. We looked at other records that told us how the home is run. This included staff records and health and safety records. Care Homes for Adults (18-65 years) Page 11 of 39 The registered manager completed an Annual Quality Assurance Assessment (AQAA) and sent this to us when we asked for it. This is a form the manager fills in and sends to the Care Quality Commission telling the inspector how the home is meeting the needs of the people that live there. What the care home does well People are given information about the home, and the chance to visit before they come to live at Coppice Lodge. Care Homes for Adults (18-65 years) Page 12 of 39 People say they are happy living at the home. People living in the home are able to enjoy an active lifestyle with lots of choices of things they can do. People who live at Coppice Lodge are supported to keep in touch with their families and friends. Care Homes for Adults (18-65 years) Page 13 of 39 People can choose what they want to eat from the healthy menu that is available. Coppice Lodge looks after people well and writes down what help everyone needs. People are supported in their medical appointments. Care Homes for Adults (18-65 years) Page 14 of 39 Staff training and development is encouraged by the manager to make sure that people who live at the home receive the best possible service. Coppice Lodge makes sure that all staff are trained to give medication safely. Staff make sure that the care provided is flexible, consistent and is able to meet the changing needs of individuals. Care Homes for Adults (18-65 years) Page 15 of 39 Coppice Lodge makes sure that suitable staff are employed and that all checks are made to keep people safe. The manager has the skills and experience to make sure the home is well run. The management team supports staff. Care Homes for Adults (18-65 years) Page 16 of 39 What has got better from the last inspection More staff have trained to develop their skills and become qualified to give support to people who live at Coppice Lodge. Redecorating the communal areas of the house is due to start. What the care home could do better Care Homes for Adults (18-65 years) Page 17 of 39 A record should be kept when medication is not given. This makes sure that there is a record to say why it was not given. A photograph for each person who takes medication should be included in the records, to make sure people are kept safe. If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 18 of 39 If you want to speak to the inspector please contact Dianne Thompson CQC (West Midlands) Citygate Gallowgate Newcastle Upon Tyne NE1 4PA 03000616161 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 set out 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 Adults (18-65 years) Page 19 of 39 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 20 of 39 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that they will be looked after by the staff at Coppice Lodge. This is because detailed assessments are completed to make sure peoples support needs can be met before they move into the home. Evidence: Coppice Lodge makes sure information is accessible to everyone who uses their service. We saw the statement of purpose, service user guide and copies of the contract agreement. The statement of purpose and service users guide has been produced in easy read format with words, pictures and photographs. This emphasis on access to information is evident for example, in the contract agreement which is also written in words and picture format. We looked at the files belonging to 3 people living at the house, including 2 people who have moved into Coppice Lodge since the last key inspection. These files show that a detailed assessment is carried out by the manager at the persons place of residence or hospital. This includes their likes and dislikes as well as their care needs. Other people such as their parents are involved if possible. A social services assessment is also included in everyones file. Where people may have particular communication or support Care Homes for Adults (18-65 years) Page 21 of 39 Evidence: needs it is important that they are able to visit the house and be given the chance to show an opinion before moving. The Annual Quality Assurance Assessment (AQAA) tells us that specific training needs are looked at for new people and staff are given this training, for example where someone has a particular communication need. The staff training file shows that some communication training has been carried out. Staff files also show that they have relevant background experience related to caring for people with high support needs and learning disabilities. The manager says in the AQAA that they involve multi disciplinary team in admissions; carry out full assessment of needs before admission including staffing requirements. We involve specialist help for our service users. Care Homes for Adults (18-65 years) Page 22 of 39 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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. Coppice Lodge keeps care plans up to date to make sure that people can be confident they will receive the support for their specific care needs. Risk assessments are in place to manage risks in a way that promotes independence. Evidence: Information obtained from care needs assessments are used to develop a care plan. A care plan tells staff about the persons care and social needs and the level of support required for maintaining their health and independence. Each person has a pen portrait to give staff information about who people are. We case tracked 3 peoples care. This is where we look at what life is like at Coppice Lodge for the people who live there. This includes looking at care plans, and seeing how health and social care needs are being met. From the care plans we could see that regular reviews are being carried out. Information provided in care plans covers areas such as likes and dislikes, diet, communication and personal care. The manager said there are plans to develop care plans into a more accessible format. Care Homes for Adults (18-65 years) Page 23 of 39 Evidence: Evidence seen in care plans includes information about the methods of communication people use or understand, such as signs and symbols, makaton, audiotapes, and objects of reference. The manager said that training from the Speech and Language therapist will help all staff develop the support they give using appropriate signs and symbols. Additional support is provided by the local behaviour team and health support team. These teams support Coppice Lodge with behaviour management plans, monitoring and analysis particularly where people have complex support needs. Examples of working behaviour plans were seen that included dos and donts for staff regarding triggers for behaviours. Engagement profiles are also included which give staff details about positive ways to engage and relate to individuals. The manager said in the services Annual Quality Assurance Assessment (AQAA) that full care plan covering all aspects of care provided; agreed and signed by service users where able; agreed at care review with all professionals and family involved with service user. All care plans contain comprehensive risk assessments and behavioural management plans. Service users meetings held. Service user questionnaires conducted annually to obtain service users views. Care Homes for Adults (18-65 years) Page 24 of 39 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 are supported to lead active and interesting lives. Staff encourage people to maintain links with their families and to develop friendships. Dietary needs are generally well catered for with a varied and healthy menu provided. Evidence: The manager said in the services Annual Quality Assurance Assessment (AQAA) that all service users are given opportunities for personal development whilst also recognizing their individual needs and capacities. Some service users have had referrals for employment opportunities. Service users abilities to manage money are recognised in their care plans and risk assessments are included where necessary. People have their weekly programme of activities, and records show that a range of activities take place in the home and in the community. These include college twice per week for some people for courses such as a taste of cookery and sensory crafts. Other activities include shopping, board games, painting, massage, cooking, relaxation, beauty sessions, social visits, pub lunches, film club, listening to music and sing-along. Care Homes for Adults (18-65 years) Page 25 of 39 Evidence: Staff commented in surveys that generally activities were taking place out of house activities are always planned .i.e. college, clubs. Others commented that the home could provide more outdoor activities for residents and with more funding a lot more day trips out and holidays, but other than that our home provides everything possible that can be provided. During the inspection people were seen spending time with staff and in the music room. Although communication with people living at Coppice Lodge was difficult, we saw how well staff interacted with the residents. Visits and contact with family and friends is supported. We saw that staff support people to visit their family members where they are unable to come to Coppice Lodge. Records show the varied and nutritional meals that are provided with alternative meals where these have been chosen. Breakfast is a choice of cereals, with toast, tea or coffee, juice, fruit. Cooked breakfasts are usually served at weekends. Main meals are served at lunch time. Lunch menu options varies from Big Mac and fries from MacDonalds, to cottage pie, with mixed vegetables, chicken curry, gammon with mashed pots and peas, carrots and onion sauce, to roast lamb with potatoes, carrots, sprouts, broccoli, cauliflower and gravy. Deserts include fresh fruit and yogurts. Tea is usually a choice of sandwiches with desert such as cheesecake, fruit and cakes. Supper is served with hot drinks and a choice of tea cakes, gateau, ginger cake or cookies. All menu records were checked for the previous month. There were no gaps and all records were up to date. Staff commented that the food is good, that everyone has a good diet. Care Homes for Adults (18-65 years) Page 26 of 39 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Details of peoples personal and healthcare needs are clearly identified in care plans and health action plans. This makes sure staff know how to give care in a way that is preferred and consistent. Coppice Lodge has a medication policy and procedure for staff to follow so that all medication is administered and stored safely so that people are kept well and safe. Evidence: Health action plans are in place to help and support people with their health care and appointments. These plans sets out how their health needs are to be met. We saw information about how people communicate uses objects of reference; information on how to look after myself giving details of personal care support to be given. We saw that peoples weight is monitored regularly, with a graph to show fluctuations, to monitor and track any changes. The health action plans also give details of prescribed medication, medication record sheets, and monitoring forms. Regular checks are being made. Records of behaviour monitoring are in place. Evidence shows how information is used to make any changes to each persons support if it is needed. We saw information to show that people have recently had health and Care Homes for Adults (18-65 years) Page 27 of 39 Evidence: medication reviews. People have good access to medical support through their doctor, clinical psychologist, behavioural team, community health care team, speech and language therapist, dentist and chiropodist as required. The manager said in the services Annual Quality Assurance Assessment (AQAA) that all service users have regular general practitioner, opticians, dental and consultant psychiatrists visits. The manager said that advocate support is sought where there are concerns about residents to make sure their needs are fully met and suitable services are obtained for them. Staff were observed providing support for people in a respectful way, making sure that each persons dignity and self esteem was important. Although people who were at home during the inspection visit were unable to communicate their views of the home, they appeared to be comfortable and at ease in their surroundings. Medication is well managed by staff at Coppice Lodge. Medication is stored securely and given to people at the right time and full records are kept which show this. A medication policy and procedure is in place and provide guidelines to follow should any medication error occur. These policies and procedures are reviewed regularly, with the most recent review completed on 27th January 2009. We checked the records for administration of medication and found that there were gaps in recording when medication had been given. It was clear that the gaps coincided with visits to parents, but the appropriate code had not been recorded to show this. The manager was advised that a code should be entered and an explanation given on the back of the record sheet to make sure there is a full audit trail for all medication. We saw instances where medication had not been given, but appropriate codes and information had been recorded. The manager was also advised that photographs of all residents who are receiving prescribed medication should be included with their medication administration record sheets. This is good practice and helps to keep people safe by making sure they are given medication as prescribed. Ordering, disposal and audit records for medication were seen. Additionally, procedures advise that errors are to be reported to the Care Quality Commission (CQC). The supplying pharmacist carries out annual audits of all medication stored in the home. The last visit took place on 2nd April 2009, and all was considered to be satisfactory. Staff survey comments include good communication and relationships with relevant professionals. We saw compliments from visiting professionals thank you for taking good care of X and providing excellent service, excellent assessment, really picked up on Xs problems. Care Homes for Adults (18-65 years) Page 28 of 39 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. People are protected by the homes safe working practices and people can be confident the staff will give them the support they need to keep them safe. People are encouraged and supported to take risks in order to be as independent as possible. Evidence: There are systems and procedures in place to make sure that everyone who lives at Coppice Lodge are kept safe. Care records contained a number of risk assessments showing potential hazards and control measures to reduce or eliminate an identified risk. For example, environmental risk assessments are in place to keep people safe in the home. In addition we saw where a risk assessment had been completed to consider ways of keeping a person safe but maintaining their independence, when they are out in the community. We saw from the records that these risk assessments are reviewed regularly or as needs change. Staff are able to access the homes safeguarding policy. This policy tells staff how to recognise different forms of abuse and how to protect people. The service makes sure people are protected through their safeguarding policy, and by maintaining accurate records and daily notes. We looked at the complaints log and records show that no complaints have been received. At the time of the inspection a referral had been made to the Adult Protection Team but has not yet been resolved. The Care Quality Commission (CQC) has not received any complaints about Coppice Lodge since the last inspection. Care Homes for Adults (18-65 years) Page 29 of 39 Evidence: The complaints procedure is made available in large print where needed. We saw a copy of the complaints procedure displayed on the notice board. This is in word and picture format to make sure everyone can access the information. Everyone who uses the service is given a copy of the complaints procedure and staff say they would support people to make a complaint should they wish to do so. Surveys told us that they would know how to make a complaint and that staff do listen to them. People we spoke to said they would know how to make a complaint. There are suitable finance procedures in place. A financial risk assessment is in place to support people in the safe management of their financial affairs. The manager states in the Annual Quality Assurance Assessment (AQAA) that all service users receive copies of our complaints procedure in a format appropriate to their level of understanding; these are reissued annually to ensure they have a copy. All relatives receive copies of our complaints procedure when service users are admitted. Local POVA policies are displayed and CQC contact information is included on our complaints procedure. Staff receive training through LDAF, in house and when they undertake NVQ training on protection of vulnerable adults. The home has a whistle blowing policy. All staff receive training in Management of Aggression and management of challenging behaviour. Care Homes for Adults (18-65 years) Page 30 of 39 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 who live at Coppice Lodge enjoy a comfortable and homely living environment. The home is spacious and is kept clean and well maintained. Evidence: Coppice Lodge is located in a residential area of Kidderminster close to local amenities with access to the bus route into town. There is a large kitchen, lounge, and music room in the communal areas of the home. Bedrooms are all single and individually furnished to residents own choices. The communal rooms are comfortable and well furnished and provide adequate space for shared activities. There is an enclosed garden to the rear of the property with easy access. The garden is well designed and landscaped with sensory areas. The sensory garden has scented and tactile areas. Walkways with different styles of lights, a water feature with lights, and seating areas have been incorporated into the design of the garden. Decorative handrails are provided for access and support around the garden. There is a grassed area decorated with flowerpots. A large trampoline with covered sides for added safety is available for people to use. Coppice Lodge has its own minibus and one of the service users has their own car. The premises are clean and tidy. Policies and procedures for infection control are in place Care Homes for Adults (18-65 years) Page 31 of 39 Evidence: and staff are provided with disposable gloves and aprons. Paper towels and liquid soap are available in the communal bathrooms. Staff records show that all staff receive training in infection control. The manager states in the Annual Quality Assurance Assessment (AQAA) that the home has a regular maintenance team to keep its appearance good and a maintenance plan for the home. There are plans to redecorate the communal rooms and work is scheduled to start in the next couple of weeks. Care Homes for Adults (18-65 years) Page 32 of 39 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 can be confident that the support they receive will be delivered by well supervised and skilled staff to help maintain their health and independence. People are supported by staff that have access to regular training and supervision, and are supported to do their jobs well. Evidence: Coppice Lodge has a committed and stable staff team. The Manager said she covers any additional shifts where needed to ensure that consistency of support is provided for everyone. The manager said the staff team are very well motivated and always look to improve the lives of the people who use the service. Coppice Lodge provides regular staff training. Staff complete mandatory training such as Health and Safety, Fire Safety, First Aid, Food Hygiene, Moving and Handling, Infection Control and Vulnerable Adults. Staff said that the training provided is very good. An in house training session, for the administration of midazolam took place during the afternoon of the inspection. Training records confirmed that regular training takes place, including induction training for new staff. The manager said in the services Annual Quality Assurance Assessment (AQAA) that staff complete many training courses relevant to their jobs. There is a training plan in the home for all staff. Over 60 of staff have NVQ level 2 or above. Regular staff meetings Care Homes for Adults (18-65 years) Page 33 of 39 Evidence: held. Regular supervision meetings are held with staff; comments on the effectiveness of courses are added to supervision notes. The AQAA tells us that Coppice Lodge has robust staff recruitment and selection procedures. We looked at staff personnel files which show that appropriate safety checks have been made to make sure staff are suitable to work with vulnerable people. These checks include a Criminal Record Bureau clearance (CRB) and two written references. These checks are completed as routine and records are well maintained. All staff are required to work a probationary period. Time was spent talking with a newly employed member of staff who confirmed that recruitment procedures had been followed and all checks carried out. Staff surveys confirmed that they are well supported although one person commented that more staff supervision was needed. Care Homes for Adults (18-65 years) Page 34 of 39 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 home is well managed and staff receive the leadership and support they need. Coppice Lodge monitors and evaluates the service provided to protect the health and welfare of people using the service. Evidence: The Registered Manager Faith Burgess is well qualified and has many years experience working with people who have learning disabilities. Faith regularly completes training relevant to her position as registered manager. Recent training has included the Registered Managers Award (RMA) due for completion at the end of the year, training in epilepsy, first aid and Health and Safety with all the staff team. Faith supervises senior staff and senior staff supervise care staff. Faith is supported by a deputy manager and senior support worker who are both qualified to RMA level. Staff confirmed that the manager is approachable and supportive. Surveys comments include the management are very hands on and help staff learn. They also provide the support. The Annual Quality Assurance Assessment (AQAA) was completed and sent to us when Care Homes for Adults (18-65 years) Page 35 of 39 Evidence: we asked for it. Discussions about quality monitoring took place with the manager. The current audit of the service will include checking records, environment, complaints received, finance and safety. Any actions that may be needed to address shortfalls will be specified. The resulting report forms an annual development plan for the service. This report includes views on the service from people who use the service, stakeholders and interested parties. All families were given copies of the complaints procedure as a result of the previous years audit, because some people had identified they had not been given a copy. Health and Safety is being well managed within the home through staff training, regular monitoring and safety checks. The Health and Safety folder contains copies of all policies and procedures together with a signing sheet for staff when they have read the information. An index to all policies and procedures makes access easy for all and shows that these are kept up to date and reviewed regularly, with 22/1/09 the most recent review. Records show that monthly checks of the fire safety system and equipment, water temperature and storage, fridge, freezers and electrical appliances are completed. Generic risk assessments are in place. Hereford and Worcester fire brigade recently carried out an inspection of Coppice Lodge and considered the premises to be satisfactory. Fire drills are carried out on a regular basis and details of everyone in attendance is recorded. Drills are supported with regular fire training that includes follow up sessions for new staff. This involves the completion of a questionnaire to check on individuals knowledge and skills. We checked maintenance records and saw that routine work is completed as needed within reasonable timescales. Details are also provided for all regular contractors, including photo identification. Care Homes for Adults (18-65 years) Page 36 of 39 Are there any outstanding requirements from the last inspection? Yes  No  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 Adults (18-65 years) Page 37 of 39 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 Description 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 Description 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 20 A code should be entered and an explanation given on the back of the medication administration record sheet when medication is not given. This makes sure there is a full audit trail for all medication. Photographs of everyone who is receiving prescribed medication should be included with medication administration record sheets. 2 20 Care Homes for Adults (18-65 years) Page 38 of 39 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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