Copper Beeches Lodge

Copper Beeches Lodge is a residential care home providing personal and nursing care to up to 13 people. The service provides support to people with a learning disability. At the time of our inspection there were 13 people using the service.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

The model of care and setting did not maximise people’s choice, control and independence. People were not supported to be as independent as possible or have as much control over their lives as possible. People spent much of their time in the service or going out as a group. Not everyone had been consulted about, or empowered to identify, any aspirations or goals they had. Where people had identified wishes or goals, these were not usually detailed as part of their planned care and support.

Activities and interests were sometimes delivered in the service rather than finding similar opportunities in the local community.

There was a risk averse culture in the service. This meant people were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Reasonable adjustments were made for people so they could participate in discussions about their day. People who experienced periods of distress had proactive plans in place which ensured restrictive practices were only used by staff if there was no alternative. Systems were in place to report and learn from any incidents with external professionals.

People’s care and support was provided in a safe, clean, well-maintained environment and people were able to personalise their rooms.

Right Care:

People did not always receive support that followed best practice and focused on their quality of life. People did not always receive the right support to develop an understanding of their aspirations or goals and live a quality life of their choosing.

There were not consistently enough staff available to provide individualised care. People did not always have the opportunity to undertake activities and pursue interests that were tailored to them as an individual; and were not routinely engaged in trying new activities. People’s care plans did not always include information to promote their wellbeing and enjoyment of life.

Positive risk taking was not always encouraged or enabled. Risk assessments were undertaken but these were sometimes basic and lacked individual detail.

People were not always protected from abuse as all staff had not received relevant training.

People received kind care from staff who responded to requests for support.

People were able to communicate with staff and understand information given to them by staff who understood their individual communication needs.

Right Culture:

The ethos and values of the service did not consistently enable people to lead confident, inclusive and empowered lives. The manager and provider had not ensured best practice was embedded in the service. This meant people’s wishes, needs and rights were not all known by staff or placed at the centre of the service.

Checks and audits were undertaken but often did not review aspects of the service that would highlight actions to enhance people’s quality of life.

Staff had received training but did not have a good understanding of best practice models of care. This meant people did not always receive tailored support that empowered them as an individual.

Staff knew and understood people well and cared for them. People and those important to them, including advocates, were involved in reviewing people’s care plans.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

This was the first inspection since the provider registered with us to run the service on 21 July 2021.

The last rating for the service under the previous provider was good, published on 12 September 2017.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We completed this inspection to provide a rating for this previously unrated service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We have identified breaches in relation to person-centred care and governance. We have also made recommendations in relation to language used in records, staffing levels, staff training and person-centred medicines management.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.