Coppice Court Care Home

Coppice Court Care Home provides nursing and personal care for people over 65 and accommodates up to 54 people in a purpose-built building divided into two separate units. The ground floor provides nursing care and support for people living with dementia. The first floor provides care for people whose main nursing needs are related to physical health needs, although people were also living with dementia or memory loss. At the time of this inspection 32 people were living in the service, 17 on the ground floor and 15 on the first floor.

People’s experience of using this service:

The service met characteristics of ‘Good’ in most areas.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Since the previous inspection, significant improvements had been implemented to ensure the breaches and areas for improvement identified had been addressed. Medicine practice and related records had been improved. The reliance on agency staff had reduced and staff training improved to ensure staff had the skills to look after people. Care records and risk assessments were being used to inform the care and support provided and to ensure a person-centred approach to care. Quality monitoring systems had been improved and were being used on a daily basis. However, the provider had not demonstrated that all quality information had been used to improve the service. This included feedback from staff on the staffing levels and the analysis of the call bell response times. These had identified that staff were rushing to complete their work and some call bells were not being answered in a timely fashion.

People at Coppice Court received individualised personalised care that responded to their nursing needs. People told us all their care needs were met in a pleasant environment by staff who were skilled, knowledgeable and kind. One person said, “The care I get is very good, there is a good atmosphere.” Another said, “Oh yes I am very well looked after, I am very happy here.” A relative said, the atmosphere is good, very friendly, staff are always respectful and kind.”

Staff assessed and responded to any risks and took measures to reduce these and to keep people as safe as possible. Staff had a good understanding of how to identify and respond to any suspicion or allegation of abuse or discrimination. Medicines were handled safely.

Staff treated people with kindness and compassion. One staff member told us, “I and the rest of the team look after people as they were a family member.” They understood people's needs, choices and histories and knew what was important to each person. Any restriction to people’s liberty were made in the least restrictive way possible to ensure people’s safety. These had been considered in line with the Mental Capacity Act (MCA) 2005.

People were supported to take part in a variety of activities that they enjoyed and were meaningful. The provision of activities and entertainment were well developed and was an important part of people’s lives. They enjoyed the interaction and stimulation that this provided. For example, one person showed us a watercolour they had recently completed. A relative said, “The activity person is remarkable, she lets them achieve at their own level in a natural pleasant way.”

Registered nurses completed clinical training which reflected the needs of people in the home. Staff worked closely with health and social care professionals to secure the best outcomes for people’s health and well-being. Visiting professionals told us staff responded to their input in a positive, professional way and worked with them for people’s benefit.

People's dietary needs were assessed, and food provided was tailored to their individual need. They were supported to eat a range of healthy, freshly cooked meals, drinks and snacks each day.

The registered manager knew people and staff well. They had established a management team that were working hard to support a quality service. They understood their responsibilities and monitored the standard of care and support provided. Complaints had been recorded, investigated and responded to appropriately.

Rating at last inspection: Requires Improvement (report published 8 May 2018).

Why we inspected: We previously inspected Coppice Court Care Home in February 2018. We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to act to make improvements. They provided us with an action plan. We inspected to follow up on the actions taken by the provider. At this inspection we found the provider was now meeting these legal requirements.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Coppice Court Care Home accommodates up to 54 older people in a purpose built building divided into two separate units. The ground floor provides nursing care and support for people living with dementia. The first floor provides care for people whose main nursing needs are related to physical health needs, although people were also living with dementia or memory loss. This includes people who have had a stroke or lived with a chronic health condition like multiple sclerosis. Both floors cared for people at the end of their lives and used community specialist support when providing this care. At the time of this inspection 39 people were living in the service, 22 on the ground floor and 17 on the first floor.

The service did not have a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Coppice Court Care Home was taken over by a new provider at the end of December 2017. The inspection was brought forward as there had been a high number of safeguarding alerts that were under investigation. There was a recognition that the new management team were working to establish full compliance with an emphasis on recruiting a stable and skilled management and staffing team.

At the time of the inspection agency staff were relied on as part of the regular staff provision including the provision of registered nurses. They did not always have the skills, experience and knowledge to look after people effectively. In addition there was no identified leadership in ensuring effective and best care for people living with dementia.

Care records and practice followed in the home did not always support or promote responsive and person centred care that ensured care was appropriate and met people’s needs. This included ensuring people were not looked after according to routine rather than in an individual way and being responsive to people’s changing needs.

Quality monitoring systems had not been fully established and was not embedded into practice. Despite a comprehensive action plan being progressed to improve the service, further areas for improvement needed attention. This included poor record keeping that could impact on care. We found the management of some medicines was not robust. This included the administration of topical creams and some ‘as required’ medicines. The provider could not be assured these were given in a consistent way.

People and their relatives were satisfied with the care and support provided and they liked the regular staff working in the service. Staff were kind and attentive and demonstrated a caring approach to people. There were enough staff to respond to people’s care needs on a daily basis. The regular staff knew people well and had formed caring relationships.

Staff employed by the service had a good understanding of safeguarding procedures and knew what actions to take if they believed people were at risk of abuse. Recruitment records showed there were systems which ensured as far as possible staff were suitable and safe to work with people living in the service. Staff had a basic understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Senior staff had a working knowledge of the MCA and DoLS and what may constitute a deprivation of liberty. They followed correct procedures to protect people’s rights.

People were supported to receive regular drinks and the meals that reflected their choices and needs. People were supported to take part in a range of activities and regular one to one time was provided to people. This ensured they had access to meaningful interaction. Visitors told us they were welcomed and people were supported to maintain important relationships and friendships.

The environment was clean and well maintained. The provider had ensured safety checks had been maintained and equipment and facilities in the service. People’s rooms were individualised. Staff respected each room as people’s own personal space.

Feedback was regularly sought from people, relatives and staff. People were encouraged to share their views on a daily basis. People were given information on how to make a complaint and said they were comfortable to raise a concern or complaint if need be.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.