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Archived: Coppice Court Care Home Requires improvement

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Reports


Inspection carried out on 9 February 2017

During a routine inspection

Coppice Court Care Home provides facilities and services for up to 54 older people who require personal or nursing care. The ground floor provides nursing care and support for people living with a dementia. The first floor provides care for people whose main nursing needs are related to physical health needs, although many had a dementia or memory loss. This includes people who have had a stroke or lived with a chronic health condition like multiple sclerosis, diabetes or chronic obstructive airways disease. Both floors were able to care for people at the end of their lives and used community specialist support when providing this care. Coppice Court Care Home also provides respite care that includes supporting people while family members are on a break, or to provide additional support to cover an illness. 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. The last registered manager left the service in August 2016. 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 the time of this inspection an acting manager was in post. They had been working in the service for six months.

People’s care plans did not fully reflect people’s care and support needs. Staff did not have clear guidance on how to meet all people’s needs in a person centred way. For example, people with specific care needs did not have these reflected in their care plans with guidelines for staff to follow. The management systems that included quality monitoring did not always ensure safe and best practice was followed in all areas. For example, records relating to topical creams were not always accurate. The provider could not demonstrate that these medicines were always administered in a consistent way.

People were looked after by staff who knew people as individuals. Staff were attentive, and treated people with kindness and compassion. They showed respect and maintained people’s dignity. All feedback received from people and their representatives was very positive about the care, the atmosphere in the service and the approach of the staff and acting manager. One relative who experienced a recent bereavement said, “They were so very caring to my mum and kind to me.”

Feedback from visiting professionals confirmed a good rapport with them and pleasant approach to people.

Staff had a good understanding of safeguarding procedures and knew what actions to take if they believed people were at risk of abuse. Staff understood the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Senior staff had an understanding of DoLS and what may constitute a deprivation of liberty and were following procedures to protect people’s rights.

Staff were provided with a full induction and training programme which provided them with the skills to look after people living in the service. The registered nurses attended additional training to update and ensure their nursing competency. There were enough staff to keep people safe and meet their needs.

People’s nutritional needs were monitored and staff responded appropriately if there were any concerns about a person’s nutritional intake. Preferences and specific diets were accommodated. People were supported to take part in a range of activities and to maintain their own friendships and relationships. Staff related to people as individuals and took an interest in what was important to them.

People were given information on how to make a complaint and said they were comfortable to raise a concern or give feedback. Complaints were investigated and responded to in a positive way. Feedback was regular

Inspection carried out on 25 and 30 July 2014

During a routine inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This was an unannounced inspection which was undertaken on the 25 and 30 July 2014.

The home provided nursing care and support for up to 57 people on two separate units. The unit on the ground floor provided care and treatment for people who had a dementia type illness. The first floor provided nursing care for older people and had up to ten allocated beds contracted to provide post-operative therapy (rehabilitation) for people who had undergone orthopaedic surgery. For the purpose of this inspection report the ground floor will be referred to as the dementia unit and the first floor will be referred to as the nursing unit.

At the time of the inspection visit 48 people were living in the home. The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People and their relatives told us they felt they were safe living at Coppice Court Nursing Centre. One person said, “Yes, I feel safe from everything.” Staff had received safeguarding vulnerable adults training and staff were able to tell us what they would do if they had any concerns. Staff had received training on the Mental Capacity Act 2005 and senior staff were familiar with holding relevant meetings when people lacked the mental capacity to make decisions for themselves. These meetings involved professionals and representatives to make decisions that took account of people’s best interests.

Care documentation contained individual risk assessments in order to keep people safe. We saw from staffing rotas that there was a stable and consistent staffing level. Staff spoken with knew people well and there were systems in place to share information on people. However, records for the people receiving rehabilitation were not consistent and accurate and did not provide clear guidance for staff to follow.

Staff told us they felt that there were enough staff on duty to meet people’s needs, although this did not take account of all social needs. One staff member said, “There are enough staff to provide good care, staff just need to be well organised.” We noted that call bells were not always responded to in a timely manner, which could put people at risk. This was raised with the registered manager for improvement.

People were encouraged or supported to make their own decisions about their food. There were systems in place to assess people’s nutritional status and to monitor and support people to eat a nutritional diet. For some people on the dementia unit the support provided did not ensure healthy eating. This was raised with the registered manager for improvement.

Care records and discussion with visiting professionals showed us that people had access to other health care professionals as and when required. Staff followed guidance from these professionals and sought additional advice when necessary.

People were cared for by kind and caring staff. Staff knew people well and responded to them individually. One person said, “They are so kind with my dad and everybody else.” There was a good level of activity and interaction taking place in the home for most people. The activity co-ordinator knew people well and facilitated activity and entertainment within and outside of the home. Links with the local church were provided and advertised in the home’s newsletter. The activity and entertainment for people on the nursing unit was not so well developed and the registered manager was aware of this and was reorganising the activity staff to address this area. Visitors told us that they were warmly welcomed and felt they could come to the home at any reasonable time. This helped to ensure people had access to the community, friends and relatives.

People were given information on how to make a complaint. People, their relatives and staff told us that they were able to raise a compliant easily and that they felt it would be dealt with effectively.

The registered manager and regional quality manager carried out regular audits. A review of satisfaction with the use of questionnaires was undertaken. Staff meetings and relative and residents meetings were minuted. This showed us that the provider checked that the service provided the care and treatment in an appropriate and safe way and that where necessary, improvements were made.

Inspection carried out on 15 August 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service, because some people who used the service had complex needs which meant they were not able to tell us their experiences. People who could, told us that the staff were kind, and that the food was good and tasty. We were also told, "Fantastic place, clean and the staff are wonderful." Relatives told us that they were kept informed of what was happening. They said that the staff were kind and informative."

During our inspection we found that people were involved in decisions about their care and treatment. Care plans were personalised and contained clear instructions on how people should be cared for and supported.

We saw that people were provided with a choice of suitable and nutritious food and drink and that the provider responded appropriately to any allegation of abuse.

The provider had ensured a good standard of cleanliness had been maintained throughout the home.

We found that there were sufficient staff experienced and qualified staff on duty to meet people�s needs. However we were told that occasionally, at certain times, staff were very busy and they had to wait for assistance. We spoke with staff who told us they attended regular training.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately.

Inspection carried out on 26 October 2012

During a routine inspection

We spoke to 12 people during our inspection visit. We also used a number of different methods such as observation of care and reviewing of records to help us understand the experiences of people who used the service.

People we were able to speak with who lived in the service told us they liked living at Coppice Court. Direct comments included, �I came for rehabilitation but I chose to stay here to live,� and �I have lived here a long time and it�s my home.� We were also told "kind staff and freshly cooked food," "My room is warm and clean," and "staff look after us very well."

We spoke with three relatives/visitors. One visitor told us �My wife has been here for 18 months and she�s well looked after; the staff are very patient with her.�

A visiting health professional said �the staff are very caring and seem eager to assist people, they follow the action plan and ensure that people receive the necessary assistance.�

Inspection carried out on 24 February 2012

During a routine inspection

Some people we spoke with were able to tell us that they enjoyed living at Coppice Court, and were happy. We were told �it�s very good� �I am really happy here� and �the food is always very good�. Other comments included �the food is okay� �it�s very good� �I�m not always listened to�.

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