Archived: Coplands Nursing Home

Updated 12 August 2016

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 provide a rating for the service under the Care Act 2014.

We undertook an unannounced inspection on 2 June 2016. The inspection team consisted of two inspectors, a pharmacy inspector, a specialist advisor and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service

Before we visited the home we checked the information that we held about the service and the service provider including notifications about significant incidents affecting the safety and wellbeing of people who used the service.

The provider also completed a Provider Information Return (PIR). The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The PIR also provides data about the organisation and service.

Some people could not let us know what they thought about the home because they could not always communicate with us verbally. We used the Short Observational Framework for Inspection (SOFI), which is a specific way of observing care to help to understand the experience of people who could not talk with us. We wanted to check that the way staff spoke and interacted with people had a positive effect on their wellbeing

.

We spoke with five people using the service and three relatives. We also spoke with eight care workers, four nurses, two domestic cleaners, two chefs, an activities co coordinator, deputy manager and registered manager.

We reviewed nine people’s care plans, seven staff files, training records and records relating to the management of the service such as audits, policies and procedures.

Updated 12 August 2016

This inspection took place on 2 June 2016 and was unannounced. Coplands Nursing Home is a care home with nursing operated by Life Style care (2011) plc. It is registered to provide accommodation with personal and nursing care for seventy nine older people who may also have dementia.

At our last inspection on 19 September 2014 the service met the regulations inspected. There was a registered manager in post at the time of our inspection. 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.

On the day of our inspection we observed that people were well cared for and appropriately dressed. People using the service said that they felt safe in the home and around staff.

Relatives of people who used the service told us that they were confident that people were safe in the home.

Systems and processes were in place to help protect people from the risk of harm and staff demonstrated that they were aware of these. Staff had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse.

Comprehensive risk assessments had been carried out and staff were aware of potential risks to people and how to protect people from harm. People's care needs and potential risks to them were assessed.

Staff prepared appropriate care plans to ensure that people received safe and appropriate care. Their healthcare needs were closely monitored and attended to. Staff were caring and knowledgeable regarding the individual choices and preferences of people.

People living in the home were elderly people who may have dementia. During the inspection we also noted there were people who had varied needs including mental health, physical disabilities and learning disabilities. There were 79 people using the person and 39 of those people had either mental health, physical and learning disabilities. The home did not have effective arrangements to manage the needs of people with such various conditions.

Records showed that staff had not received the received training to support people with learning and physical disabilities which meant people were at risk of receiving care that was not appropriate to their needs.

The home was not catering to people’s needs effectively. The floors which catered for people with dementia, elderly people, younger people with learning and disabilities were identical which made it made it difficult to differentiate between the units. The décor looked the same, there was no clear signage as to what each unit was, no extra lighting or contrasting colour scheme so people could easily navigate and be familiar with their surrounding environment.

There were some activities available for people using the service. The activities plan for the home included generic activities such as ball games, bingo, floor games. Although there were some activities going on in the home during the inspection, we did not observe any activities catered specifically to people with mental health, physical and learning disabilities.

During the inspection, we observed people taking part in a food tasting and smelling activity. Care workers during this social activity were very kind and compassionate however some people found it difficult to engage and were just sitting there. On the second day of the inspection, people were engaged with light exercises which was conducted by one of the relatives who volunteered to do this every Friday. In the afternoon, people were watching a film in the lounge area.

On the day of the inspection, there were sufficient numbers of staff. Most staff told us that shifts were adequately covered and they were supported. During the inspection staff were not rushed or under any pressure. The registered manager told us that they did not use agency staff to ensure consistency and recruited extra staff if needed.

Systems were in place to make sure people received their medicines safely. Arrangements were in place for the recording of medicines received into the home and for their storage, administration and disposal.

There was an infection control policy and measures were in place for infection prevention and control. Infection control audits had been carried out and a cleaning schedule was in place which allocated cleaning responsibilities to housekeeping staff to ensure that the home was kept clean

Although the home was adequately clean, there was a musty odour throughout the home and it felt stuffy. The registered manager told us the home was in the process of being totally refurbished and issues raised with regards to the premises would be rectified once the refurbishment was completed.

Staff had been carefully recruited and provided with induction and training to enable them to care

effectively for people. They had the necessary support, supervision and appraisals from management.

Staff we spoke with had an understanding of the principles of the Mental Capacity Act (MCA 2005). Capacity to make specific decisions was recorded in people's care plans.

The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS ensure that an individual being deprived of their liberty is monitored and the reasons why they are being restricted is regularly reviewed to make sure it is still in the person's best interests. The home had made necessary applications for DoLS and we saw evidence that authorisations had been granted and some were awaiting approval.

There were suitable arrangements for the provision of food to ensure that people's dietary needs were met. People were mostly satisfied with the meals provided. However during the inspection,

there were instances in which people were not being supported effectively with their lunch.

We discussed this with the registered manager who told us she would review the arrangements for mealtimes to ensure the atmosphere was improved.

Staff were informed of changes occurring within the home through daily staff meetings as well as quarterly staff meetings. Staff told us that they received up to date information about the service and had an opportunity to share good practice and any concerns they had at these meetings.

There was a management structure in place with a team of care workers, kitchen staff, domestic staff, maintenance staff, receptionist, activity co-ordinators, an administrator, deputy manager, registered manager and the provider. Staff spoke positively about working at the home. They told us management staff were approachable. They said that they did not hesitate about bringing any concerns to the registered manager.

There were systems in place to monitor the quality of the service however we found some

deficiencies in the service had not been identified.

Relatives spoke positively about management in the home and staff. They said that the registered manager was approachable and willing to listen. Complaints had been appropriately responded to in accordance with the home’s policy.

We made one recommendation about seeking advice and guidance from a reputable source about adjustments required to meet the needs of people living with dementia.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the registered manager to take at the back of the full version of this report.