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Archived: Coppice House Good

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Reports


Inspection carried out on 5 March 2015

During a routine inspection

This inspection took place on 5 March 2015 and was unannounced. Coppice House provides accommodation and personal care for up to eleven people with a learning disability or autistic spectrum disorder. The home comprises of the main house and an adjacent four bedroomed bungalow with a one bedroom annexe attached to it. Most people used the facilities in the main house during the day.

A registered manager was in place as required by their conditions of registration. 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 and associated Regulations about how the service is run.

At our previous inspection on 12 August 2014, the provider did not meet all the legal requirements in relation to the care and welfare of people. Following this inspection, the provider sent us an action plan to tell us the improvements they were going to make. During this inspection we looked to see if these improvements had been made. We found that improvements had been made to ensure people were cared for in a personalised way. People’s care and support needs were assessed, monitored and recorded in their care records.

People had complex needs and required a higher level of support and monitoring to ensure their safety. The registered manager and staff understood their role and legal responsibilities in assessing people’s mental capacity and supporting people in the least restrictive way. Risk assessments and guidance was provided to staff on how to support people. Some people required continuous support and were restricted from entering some rooms.

People and staff could raise any concerns or issues about abuse with the team and registered manager. People had been given training on how to recognise and understand the types of abuse. Staff and the registered manager understood their role to protect people from harm and abuse. Systems were in place to protect people from abuse such as daily auditing of people’s finances. Relatives told us that any day to day concerns which they had raised were always dealt with immediately.

People were supported by staff who had been suitably trained and recruited to carry out their role. There were sufficient numbers of skilled staff to meet the needs of the people they supported. Some people required individual support to help them achieve their goals. People who were able to express their views and relatives told us that staff were caring and gave them the support they needed.

People’s care was focused around their individual needs and support requirements. Their care records gave staff guidance on how to support them and reduce the risk of harm especially if they became upset. People were supported to access health care services such as dentists and specialist doctors. Their medicines were ordered, stored and administered in an effective way. Staff knew people’s preferences in food and special diets which were catered for.

Relatives spoke highly of the staff and the registered manager. Staff knew people well and were able to support them effectively in the least restrictive way to take part in activities. There were a wide range of individual and group activities in the home and throughout the community offered to people. People enjoyed meeting up with other people at community events such as discos.

Monitoring systems were in place to ensure the service was operating effectively and safely. Internal and external audits were carried out to continually monitor the service provided. The registered manager was knowledgeable in supporting people to ensure they were protected and safeguarded from harm.

Inspection carried out on 12 August 2014

During a routine inspection

Eleven men were living in the home on the day of our inspection.

The registered manager currently shown on our records had confirmed their intentions to deregister from their post. They told us they were remaining as a senior member of the staff team. A new manager has been appointed and had commenced in post. They had submitted an application to become the registered manager, to the Care Quality Commission. These changes had been implemented in the home, but had not been confirmed by the Care Quality Commission at the time of our inspection. The new manager was on leave on the day of our inspection.

We were given a tour of the home and the grounds. We spoke with a representative of the provider, two senior members of staff and three members of care staff. We read the care records for four people who lived in the home. We inspected the policies and procedures, the complaints folder, the safeguarding folder and read reports from quality monitoring visits.

We were unable to speak with people who used the service. They had limited communication skills and were unable to provide us with feedback, and so we observed their interactions with staff during the day. We saw that people appeared comfortable and relaxed with staff, and we saw that staff appeared to communicate effectively with people who responded verbally and non verbally.

A single inspector carried out the inspection. The focus of the inspection was to answer five questions: Is the service safe, effective, caring, responsive and well-led?

We found the service was safe.

Staff told us they had received training about safeguarding vulnerable people. They told us they would report concerns to senior staff. Policies, procedures and local guidelines were available for staff to follow. Staff told us they were issued with 'cards' which they were expected to carry with them. These had contact numbers for staff to use if they needed to 'whistle blow' or report any issues they were worried or concerned about.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS), which applies to care homes. The provider had policies and procedures in place in relation to the Mental Capacity Act (2005). Several people had Deprivation of Liberty Safeguards authorised by the local authority, because they did not have the capacity to consent to living in the care home, or the capacity to agree to several restrictions that were applied within the care home and which were in their best interests.

We found the service was effective.

We spoke with staff who told us they had received an induction when they had started working in the care home. They also told us they received regular supervision and appraisals. This meant that people could feel confident that they were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

We saw involvement from other health professionals such as the community learning disability team (CLDT). We also saw that some people benefitted from the support of the psychology team employed by the provider. A member of the team met with people on a one to one basis, and provided support, advice and guidance for staff.

We found the service was caring.

We spoke with staff and observed the interactions they had with the people they supported. We saw appropriate and supportive interactions. We saw that staff generally appeared to have a good rapport with the people they were supporting. We did hear one interaction from a member of staff that we found was not respectful, was not in accordance with their individual care plan and was discriminatory. We have asked the provider to confirm what actions they are taking to meet the requirements of the law

We found the service was not responsive.

People had their needs assessed on a regular basis. Key workers completed monthly reviews of daily care records. Senior staff completed monthly updates of care plans. We saw that annual reviews were completed.

For one person, we were provided with records that confirmed they were given inappropriate food and drinks. This meant that the person did not consistently receive the care required to ensure their safety and welfare. We have asked the provider to confirm what actions they are taking to meet the requirements of the law.

We found the service was well-led.

We saw that people were asked for their feedback. Meetings were held with people who lived in the care home, and staff supported people to express their views at these meetings. We saw that people who used the service required significant support to communicate.

Action plans were devised by the manager in response to feedback and to quality and compliance monitoring visits from the provider.

Incidents and accidents were documented and reported. These were reviewed by the provider and actions agreed where needed.

Inspection carried out on 15 May 2013

During a routine inspection

Due to the nature of the service, we were not able to speak to any person who used the service. However, we spoke to staff and inspected documents that were held by the service.

We saw evidence that people who used the service were involved in the development of their care plans and risk assessments. We looked at the care files for three people who used the service. The deputy manager told us that staff had recently started contacting people�s families every two weeks to make sure contact was maintained. The care files were up to date and comprehensive. Care plans and risk assessments had been reviewed regularly and reflected individual people�s needs.

The provider had a medicines policy in place that was fit for purpose and being reviewed at the time of our visit. Staff were trained in administering medicines and had their competencies checked yearly. Both the deputy manager and the staff we spoke to told us that the staffing levels were good in the home and met people�s needs. The deputy manager told me that the staff did all they could to resolve any concerns quickly and at the time they were raised. This was confirmed when we spoke to staff and also in the satisfaction surveys from relatives.

We saw positive comments from one parent who said �I am happy with the care my son gets, I also get good information from the staff�.

Inspection carried out on 13 June 2012

During an inspection in response to concerns

Because of the nature of the service, we were only able to speak to one person who used the service. They told us that they liked living at Coppice House, especially the food that was available.

However, we saw other feedback from relatives and local authorities.

One local authority said that they were happy and confident in Coppice House for their client. A relative had also said that they were pleased at the progress the person was making at Coppice house.

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