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Inspection carried out on 20 November 2018

During a routine inspection

Copper Beech is a care home without nursing which is registered to provide a service for up to four people with learning disabilities and some with physical disabilities. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. There were three people living in the service on the day of the visit. All accommodation is provided within a single-story building within a village style development. Each person had their own self-contained flat and there were no immediate plans to increase the occupancy to four.

This unannounced inspection took place on 20 November 2018. At this inspection we found the service remained Good overall.

Why the service is rated Good overall:

There is a registered manager running the service who is also the registered manager for a separate adjacent service. 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.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People’s safety was maintained by staff who had been trained in safeguarding vulnerable adults and health and safety policies and procedures. Staff clearly understood how to protect people and who to alert if they had any concerns. General environmental/operational risks and risks to individuals were identified and appropriate action was taken to eradicate or reduce them. We have made a recommendation in respect of the frequency of fire safety equipment checks.

There were enough staff on duty at all times to meet people’s diverse, individual needs safely and effectively. The service benefited from a stable and experienced staff team. The provider had robust recruitment procedures. People were given their medicines safely, at the right times and in the right amounts by trained and competent staff.

Staff were well-trained and able to meet people’s health and well-being needs. They were able to respond very effectively to people’s current and changing needs. The service sought advice from and worked with health and other professionals to ensure they met people’s needs.

People were encouraged to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practise.

The committed, attentive and knowledgeable staff team provided care with kindness and respect. Individualised and person-centred care planning ensured people’s equality and diversity was respected. People were provided with a range of activities, according to their needs, abilities, health and preferences. Care plans were reviewed by management staff regularly. Care plans contained up to date information and records demonstrated that risk assessments were reviewed within stated timescales.

The registered manager was highly regarded by staff and family members. She was described as supportive, approachable and very focussed on the needs of the people living in the service. The very good quality of care the service provided continued to be reviewed and improved, as necessary.

Inspection carried out on 8 March 2016

During a routine inspection

This inspection took place on the 8 March 2016 and was unannounced.

Copper Beech is a care home which is registered to provide care (without nursing) for up to four people with a learning disability. The home is a large detached building situated on a village style development together with other similar care homes run by the provider. It is situated some distance from local amenities and public transport. There are four self-contained flats and at the time of the inspection three people were living in the home.

The registration certificate on display was not up to date. The manager undertook to complete the necessary forms to ensure that the certificate accurately reflected the service provision. There was a registered manager for the service who worked 24 hours per week. 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.

The recruitment and selection process ensured people were supported by staff of good character. There was a sufficient amount of qualified and trained staff to meet people’s needs safely. Staff knew how to recognise and report any concerns they had about the care and welfare of people to protect them from abuse.

People were provided with highly effective care from a core of dedicated staff who had received support through supervision, staff meetings and training. People’s care plans detailed how they wanted their needs to be met. Risk assessments identified risks associated with personal and specific behavioural and/or health related issues. They helped to promote people’s independence whilst minimising the risks. Staff treated people with kindness and respect and had regular contact with people’s families to make sure they were fully informed about the care and support their relative received.

The service had taken the necessary action to ensure they were working in a way which recognised and maintained people’s rights. They understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people in their care.

Staff were supported to receive the training and development they needed to care for and support people’s individual needs. People received very good quality care. The provider had taken steps to periodically assess and monitor the quality of service that people received. This was undertaken by the home manager and the deputy manager through internal audits, through care reviews and requesting feedback from people and their representatives.

Inspection carried out on 19 and 20 March 2015

During a routine inspection

The inspection took place on 19 and 20 March 2015 and was unannounced. Copper Beech provides residential care for up to four people with learning disabilities and autism. At the time of our inspection three people were living in the home.

The home is on a single level. Self-contained flats provided independent accommodation for each person, with additional communal facilities including a kitchen and lounge. This enabled people to join in with group activities and socialise together. Copper Beech is one of 13 homes in Ravenswood Village, managed by the provider for people with learning disabilities, autism and physical disabilities. Community facilities, including a swimming pool, café and stables, are located within the Village for people’s use.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 the time of our inspection, the registered manager was on planned long term leave. The provider had informed us of interim measures to manage the home. The deputy manager had been temporarily promoted to cover management duties, and is referred to as the manager within this report.

During this inspection we checked whether the provider had taken action to address the regulatory breach we found during our inspection in July 2013. This related to the poor state of the home, which required refurbishment to address the issues identified. The provider told us they would complete the actions required by the end of December 2014, as there was a planned conversion to provide people with individual flats within the home. Building work had been delayed, but was in the final stages to address minor snagging issues at the time of our inspection. The actions required to meet the concerns identified at our inspection in July 2013 had been completed.

Although the Medicines Administration Records (MARs) documented that people received and took their prescribed medicines, these were not always completed promptly once medicines had been administered. Stock checks of medicines held in the home did not always correlate with people’s MARs. Inaccurate stock checks and records meant there was a risk that sufficient medicines may not be available to meet people’s prescribed doses.

Medicines were administered, stored and disposed of safely. Equipment was checked and serviced in accordance with manufacturers’ guidance to ensure people, staff and others were not placed at risk of harm. However, records of monitoring checks and audits within the home, such as recording and reviewing people’s weights, had not always been fully documented. Risks to people from these omissions were reduced because people received one to one support throughout the day. Staff were observant and caring, and understood the actions required to protect people from harm.

People were supported by sufficient staff who were trained to ensure they received the care they required. The manager had identified that some training required refreshing, and had arranged time for staff to attend to this. People’s specific health, emotional and dietary needs had been identified, and staff followed the provider’s guidance to ensure these needs were met effectively. Robust recruitment checks ensured people were supported by staff suitable for the role. Communication within the home and liaison with health professionals meant people’s needs and preferences were appropriately supported.

People’s rights and wishes were promoted through effective implementation of the Mental Capacity Act 2005. Staff understood the actions to take if a person was assessed as lacking the mental capacity to make an informed decision. The manager understood and followed the requirements of the Deprivation of Liberty Safeguards.

Relatives described staff as caring and loving. We observed staff treated people with respect and affection. They took care to promote people’s dignity and privacy. They listened to people’s comments, and supported them as they wished. Where people were unable to verbally communicate their wishes, staff understood the communication methods people used to indicate their preferences.

People’s needs were regularly reviewed with them, and six monthly reviews held with them and their relatives. Risks to people’s health and wellbeing were identified and assessed to ensure people and others were protected from potential harm. People attended and participated in a range of activities within the home, Village environment and wider community. These activities were specific to each person’s preferences. People and their relatives were regularly asked for their views of the home and the care people received, and these views influenced changes to people’s support plans.

Staff told us they felt supported, and could approach managers and the provider for advice at any time of day or night. Effective communication and discussion of issues ensured that learning was shared, and drove improvements to people’s daily lives in the home. The provider’s values were reflected in the culture of the home, such as providing person-centred care, and learning from feedback to ensure people experienced a high quality of care.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to 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.

Inspection carried out on 19 July 2013

During a routine inspection

We were unable to gain verbal feedback about the quality of services from the six people who live at the home, as they had limited verbal skills. However, we spent time observing how staff were interacting with people who live there. It was clear from talking with staff that they knew the needs of each individual well and were mindful of their particular preferences and wishes. Self-care was prompted with sensitivity and patience.

We saw person-centred care plans had been developed to reflect the particular needs, wishes and interests of people at the home. They contained information about how people wished to spend their time and how they wanted to be supported.

We found the home was generally in a poor state of repair. Paint was missing from some of the woodwork in the communal areas. Walls were badly marked and had chipped plaster. We were told of plans to redevelop the existing home into three self-contained flats for three of the current residents. The other three people will be moving to alternative accommodation outside of Ravenswood village.

Inspection carried out on 30 March 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. We spent time observing how people interacted with staff and their general well being. We also spoke with their support staff. We spoke with three members of staff who all had a good knowledge of people's care needs and their preferred routines.

We looked care records for five people and found that people's needs had been assessed and care plans developed to meet their needs. We saw that care records contained relevant information for staff to meet people's individual care needs.

Training records showed that staff completed an induction followed by an ongoing programme of training with updates as required. We spoke with three members of staff who told us that the training they received gave them the necessary skills to carry out their jobs appropriately.

We saw that the provider had an effective system to regularly assess and monitor the quality of service that people receive.

Inspection carried out on 20 March 2012

During a routine inspection

We were unable to fully verbally communicate with people living at Cooper beech and we did not fully understand their communication methods. Therefore we spent time observing the interactions between the staff and people living in the home to attempt to gain an understanding of their experiences.

The staff knew people well and they used body language, facial expression and communication aides to facilitate communication. The staff explained that people often understood spoken language but they did not always respond verbally.

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