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Archived: Coppice Lodge Requires improvement

The provider of this service changed - see new profile

Reports


Inspection carried out on 31 May 2017

During an inspection to make sure that the improvements required had been made

We carried out an unannounced comprehensive inspection of this service on 25 and 26 October 2016. At which two breaches of legal requirements were found. This was because the registered provider checks and audits did not assess, monitor and drive improvement in the quality and safety of the services provided. In addition, the registered provider had not made all relevant notifications to Care Quality Commission (CQC). A notification is information about important events which the provider is required to send us by law and CQC requires this information to look at the risks to people who use care services.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We undertook a focused inspection on the 31 May 2017 to check that they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to these requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Coppice Lodge’ on our website at www.cqc.org.uk’

Coppice Lodge is registered to provide accommodation and personal care for a maximum of eight people. There were seven people living at the home on the day of the inspection.

There was a registered manager in place who is also the registered provider. 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.

Since the last inspection the provider had made changes to the staffing team and had appointed three senior carers to provide further support to staff and develop lead roles within the home. Staff told us that supervisions and staff meetings were now in place and that they were able to ask for advice and support when needed from the senior carers. Staff told us this supported them to provide more responsive care. We saw that senior care staff had recently completed supervision training to support the completion of regular staff supervisions.

All staff we spoke with said there had been improvements in the management of the service and this had a positive impact on the care and support provided. Staff told us people were being supported with more responsive care, for example, there were now more activities within the home based on people’s individual choices

Checks and audits were now in place to monitor and drive improvement in the quality and safety of the services provided. For example, there was now a system of audits to record and monitor accidents and incidents in place to identify trends, so staff could take appropriate action to reduce the likelihood of events from happening again.

Records showed notifications had been made as required to CQC. A system was now in place to record and monitor Deprivation of Liberty (DOL) applications and authorisations. However, we found that whilst improvements had been made, the provider needed to review systems used to ensure they were robust enough to identify all instances when action needed to be taken.

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Inspection carried out on 25 October 2016

During a routine inspection

The inspection was unannounced and took place on 25 and 26 October 2016. The home is registered to provide accommodation and personal care for a maximum of eight people. There were seven people living at the home on the day of the inspection.

There was a registered manager in place who is also the registered provider. 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.

At our comprehensive inspection on 14 August 2015, we found that people living at the home received their medicines; however systems and processes were not in place to provide an accurate count of medicines and to review usage. This inspection found improvements had been made. We found there was a record of PRN (as required) medicines. A medicines order and stock record had been introduced and staff told us medicine management had improved.

Relatives told us that people were safe and well cared for. Staff were able to demonstrate they had sufficient knowledge and skills to carry out their roles effectively and to ensure people who used the service were safe.

People were cared for by staff who were trained in recognising and understanding how to report potential abuse. Staff knew how to raise any concerns about people’s safety and shared information so that people’s safety needs were met. Staff were available to people and supported them to take their medicines when needed.

The registered provider was aware of their responsibilities in regard to the Deprivation of Liberty Safeguards (DoLS). Staff sought the consent of people before providing care and they could choose the support they received.

People’s nutritional needs were met but the choice of meals could be improved. People were supported with drinks throughout the day. People were supported to access health care professionals and staff were responsive to the advice received in providing care.

People were comfortable around staff providing care and relatives told us people had developed good relationships with staff. Relatives told us people’s privacy and dignity was maintained by caring staff and we made observations that supported this.

People were supported to enjoy various activities outside of the home; however they did not always receive support to engage in meaningful activities to meet their personal needs within the home.

Relatives said communication was good and staff and the registered provider were available to them. They said staff listened to them and they felt confident they could raise any issues should the need arise.

At our comprehensive inspection on 14 August 2015, we found that effective systems were not in place to enable the registered provider to assess, monitor and improve the service. We were given information about improvements to be made which we followed up at this inspection, to see what impact had been made in improving the care to people.

We found that some improvements had been implemented, for example, introduction of a medicine order and stock record, but further action was required to ensure that changes were embedded and further improvements made in a timely way. For example, completion of picture menus to support people’s choice at meal times. a process to monitor accidents and incidents to identify trends to reduce the likelihood of events happening again; structured supervisions and staff meetings to support staff to provide more effective care.

We found some statutory notifications including information about important events which the provider is required to send us by law had not always been made by the registered provider.

You can see what actions we told the provider to take at the back of the full version of this report.

Inspection carried out on 14 August 2015

During a routine inspection

The inspection was unannounced and took place on 14 August 2015.

The home is registered to provide accommodation and personal care for a maximum of eight people. There were seven people living at the home on the day of the inspection. There was a registered manager in place who is also the registered provider. 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.

People living at the home received their medicines; however systems and processes were not in place to provide an accurate count of medicines and to review usage. There was a risk of people’s medicines not being available and administered to them as prescribed to meet their health needs.

Staff had been recruited following the appropriate checks on their suitability to support people living in the home. Staff were available to meet people’s needs promptly and they demonstrated good knowledge about people living at the home. Staff received training to provide appropriate knowledge to support people and the staff felt supported by the registered manager.

Relatives told us they felt staff were caring and that they knew how to look after people who lived at the home. Staff showed us that they knew the interests, likes and dislikes of people. We saw that staff ensured that they were respectful of people’s choices and decisions. Where people were unable to make specific decisions about their care these were made on their behalf in their best interests.

People had access to healthcare professionals that provided treatment. Staff showed knowledge of people’s health needs and their relatives were informed of any changes in their family member’s health.

Relatives of people living at the home knew how to make complaints and told us they would speak to staff and the registered manager about any concerns. The registered manager advised that any concerns were picked up and dealt with immediately.

People living at the home were supported to take part in activities and the provider had taken actions, for example, increasing staffing at certain times, to support these.

The recording and reporting of incidents and accidents was inconsistent. When incidents occurred, action was not taken to review and reduce the risk further incidents from occurring.

Effective systems were not in place to enable the provider to assess, monitor and improve the service. The registered manager confirmed that audits were not completed and whilst they advised that management meetings were held and they walked around the home environment each week to pick up concerns and observe staff, there was no examples of any actions taken in response to these.

Inspection carried out on 20 May 2013

During a routine inspection

We inspected Coppice Lodge and spoke with some people who lived at the home and with some staff on duty. We also looked at care records for three people and other supporting documents for the service. We spent some time with the registered manager at the service.

Consent had been obtained from people before care and treatment had been provided. Alternative arrangements had been made to support people who were unable to consent to their treatment or support. Staff told us they: �Always ask people if it�s ok or if they are happy with me giving care before I give it�.

People�s needs had been assessed and care and treatment was planned and delivered in line with their individual care plan. Staff told us they were aware of each person�s needs and how to give care and support to meet those needs.

Staff told us how they supported people and helped them with their support needs. We saw that staff were kind and caring in their approach to people who lived in the home.

Recruitment procedures were in place to make sure that suitable staff were provided to care for people.

We found that any comments and complaints people made were responded to appropriately.

Reports under our old system of regulation (including those from before CQC was created)