Cooper House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

The provider was previously in breach of legal regulation in relation to the maintenance of the environment and contingency planning.Enough improvements were found at this assessment and the provider was no longer in breach of this regulation.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Robust procedures were in place for addressing incidents, accidents and complaints. Lessons were learnt to continually identify and embed good practice.

Staff listened to concerns about safety and investigated and reported safety events. One staff member told us, “If there is an incident, we have a reporting system we follow. Forms are completed describing what happened, what we did and who we contacted. Managers treat incidents seriously and families are always informed. The communication is good between us all [staff] and everyone knows when an incident has occurred and any changes that are made."

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The provider undertook an assessment of individuals needs prior to being admitted to the service. This was in consultation with the person, their families and where relevant any other professionals involved in their care. Information was kept up to date to ensure seamless transition to another service if required. Care plans were held electronically with staff using portable devices to access information in ‘real time’. The deputy manager told us, “On admission to the home people have an initial care plan put in place and this is developed over time as the person settles into the service. We regularly review these plans or when there has been a sudden change in people’s needs.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect.

The provider shared concerns promptly and appropriately with statutory agencies in line with their responsibilities. Deprivation of Liberty Safeguards (DoLS) had been applied for, and best interest decisions made, where people lacked capacity to make informed decisions and consent to their care. There was a process in place to track and monitor DoLS application authorisations and subsequent reviews.

Staff had received training in safeguarding people from abuse and were aware of how to raise any concerns. A staff member told us, “I would not hesitate in raising any concern and am confident managers would listen to me. I have no concerns for how people are cared for here.” All the people and relatives we spoke with told us they felt safe. One person said, “I feel very safe here and well looked after.” A relative said, “I feel that [family member] is totally safe here. The thought of them not being safe has never entered my mind.”

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Care plans and risk assessments were individualised and guided staff on how to manage people’s known risks safely. These included risks to people’s mobility, skin integrity, and nutrition and hydration, and how these should be managed. This meant staff were able to support people safely. One staff member told us, “The care plans are reflective of people’s needs and risks.”

People and relatives were involved in managing risks. Two relatives confirmed they were involved in introducing preventative measures to reduce the risk of their family members falling. Both told us assistive technology had been put in place for their family members which provided them with reassurance. One said, “There is a mat by the bed with a sensor so if they get off the bed they [staff] know.” The second said, “[Name] is at risk of falling. Staff have put an alarm by the bed and provided a neck pendant.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The equipment and facilities were monitored and managed safely to ensure people and staff were not exposed to any risk. External contractors undertook routine safety and compliance checks of the premises and equipment, including electrical installation and fire systems. Bedrooms and communal areas were kept free from hazards that could pose risk of injury.

Concerns identified at our previous assessment with the supply of hot water at the service had been resolved. One person said, “The water is quite warm and nice when they administer my personal care.” A relative said, “There is no problem with the water temperature.”

At our previous assessment there were no timescales in place to address environmental improvements the provider had identified within their action plan. At this assessment we reviewed their current action plan and found timescales were in place for future improvements and works carried out prior to the assessment had been made with accompanying timescales. We found the system and process in place for service improvement was now robust.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, training and supervision. A consistent staff group worked together well to provide safe care that met people’s individual needs.

The provider had systems in place to determine staffing levels which were reviewed regularly. However, we identified a shortfall in senior staff working on night shifts from the rotas we reviewed. Managers told us that newly recruited night senior staff were awaiting recruitment checks prior to commencing their role which would provide consistent senior staff on night shiftsgoing forward. As an interim measure, the provider had arranged staff from their other homes to work at Cooper House as senior care staff, with additional support provided by on call managers. Following the assessment, we were provided with assurances that the gap in night seniors was now resolved. The provider had a robust recruitment policy which showed pre- employment checks were undertaken to ensure appropriate staff were employed.

We observed staff were on hand in a variety of roles to provide care and support. This included suitable numbers of care staff who responded promptly to people’s requests for support. All areas of the service were being routinely monitored by staff including bedrooms, communal areas and outside spaces. Ancillary staff including, laundry, domestic, maintenance and activities were all deployed in sufficient numbers to ensure these areas of the service functioned well. No one we spoke with told us of any concern in relation to the numbers of staff on duty although there was some mixed feedback on how often staff had time to sit with people beyond assisting them with their needs. One person said, “There are enough staff, and they are all regular ones working different shifts.” Another person said, “There are enough staff to look after me, but they don’t always have time to sit with me.” A relative said, “There seems to be enough staff there when I visit including weekends and evenings.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The service and equipment were visibly clean, free from odour and risks associated with infections were assessed. Regular checks and audits of cleanliness and hygiene ensured the infection prevention and control (IPC) measures were managed effectively. Staff had received training in infection prevention and control.

Staff we spoke with raised no concerns over the cleanliness of the service and had ready access to personal protective equipment (PPE). A member of staff told us, “We always have PPE available and discard this in the clinical waste bins after use. The home is always clean and well maintained.” People and their relatives provided positive feedback on the cleaning arrangements at the service. One person told us, “The environment here is always clean and always tidy.” A relative said, “Everywhere is always clean, they are always cleaning.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People received their medicines safely and as prescribed.

Medicines were administered and stored safely, and records of administrations were kept. Where people were prescribed medicines on a ‘as and when required’ basis there were protocols in place to ensure people received these appropriately. We found medicine reviews had been requested when people were taking these medicines regularly.

Staff who administered medicines had been trained to do so. We observed a medicine round and staff followed best practice. Competencies of staff practice were undertaken by the registered manager. Medicines were audited regularly and any discrepancy recorded.