Background to this inspection
Updated
24 June 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The team consisted of one inspector.
Service and service type
The Coppice is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service is required to have a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of inspection there was no one registered with the Commission to manage the service.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We used all of this information to plan our inspection.
During the inspection
We spoke with one person who used the service and observed an additional two people living at the service. We spoke with six members of staff including the manager, deputy manager and support workers. We observed people living at the service.
We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data, quality assurance records and staff recruitment files.
Updated
24 June 2021
About the service
The Coppice is a residential care home providing personal care to people with a learning disability or autism. The Coppice is registered to support up to seven people. At the time of the inspection there were six people living at the service. The Coppice is an adapted building set across two floors with gardens to the front and rear.
People’s experience of using this service and what we found
People were not always supported safely with their medication. Further improvements were required to ensure prescribed fluid thickening agents were used safely. Risks to people were not always assessed, reviewed and monitored in relation to the use of bed rails and fire safety.
People received support to eat a healthy and nutritious diet and had access to medical interventions when required. The layout of the home was spacious and accessible.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Audits to monitor and improve the service had not always been completed and this had impacted on the service identifying areas for improvement. There was not always sufficient oversight from a manager at the service. Staff told us, following a recent change in the management team, a manager had been present at the home most days and that they were starting to see improvements.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
• Model of care and setting maximises people’s choice, control and independence
The home was spacious and adapted to meeting people’s changing needs. People were supported to make their own decisions and included in the day to day running of the home. This included choosing menus, going shopping and accessing the community. People were able to access timely support from health and social care professionals.
Right care:
• Care is person-centred and promotes people’s dignity, privacy and human rights
People were treated in a dignified manner and staff were aware of people’s support needs. Staff were observed talking to people in dignified and respectful way. Staff delivered personal care when people needed it and gained consent prior to providing any support.
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives
Staff told us there was a lack of leadership, but this had recently improved. Staff were caring and worked positively with people living at the home.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (23 November 2018).
Why we inspected
We received concerns in relation to infection control and staffing. We reviewed the information we held about the service. As a result, we undertook a focused inspection to review examine those risks in the key questions of safe, effective and well-led only. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report. Following the inspection the manager provided confirmation that thickener was now in stock and that risk assessments are being updated.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Coppice on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to the management of risks and medicines at this inspection.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.