Copperdown Residential Care Home

Copperdown Residential Care Home accommodates up to 29 people in one adapted building. At the time of the inspection there were 25 people using the service.

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

People received their medicines safely. However, we found that audit systems in place could not sufficiently identify the numbers of medicines people had in stock.

There was no guidance in place to support staff on escalation processes where peoples recommended fluid intake was not met.

People told us they felt safe in the home.

Relatives gave positive feedback on the care that their loved ones received.

The provider was given further guidance on infection control procedures in the home.

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

Rating at last inspection

The rating at the last inspection was good (report was published on 23 October 2018). You

can read the report from our last comprehensive inspection by selecting the 'all reports' link for Copperdown residential care home on our website at www.cqc.org.uk.

Why we inspected

We received concerns in relation to people's safety. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

The ratings from the previous comprehensive inspection for those key questions not looked at on this

occasion were used in calculating the overall rating at this inspection. The overall rating for the service has

changed from good to requires improvement.

We have found evidence that the provider needs to make improvements. Please see the safe and well led

sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

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 will continue to discharge our regulatory enforcement functions required to keep people safe and to

hold providers to account where it is necessary for us to do so.

We have identified a breach of Regulation 17 (Good Governance) of the Health and Social Care act 2008 (Regulated activities) Regulations 2014. The registered person had not established an effective system to enable them to assess, monitor and improve the quality and safety of the service provided.

Follow Up

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At this inspection we found improvements had been made and the service is rated as Good overall.

Copperdown is a Residential Care Home. 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.

Copperdown Residential Care Home accommodates up to 29 people in one adapted building. At the time of the inspection there were 25 people using the service.

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 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.

Governance systems were not always effective in identifying concerns and driving improvements whilst some improvements had been made, following our last inspection, more were needed.

People received their medicines as prescribed. Risks to people were assessed and planned for. There were sufficient staff available to meet people’s needs and staff were safely recruited. People were protected from the risk of cross infection and safeguarded from abuse. The provider learned when things went wrong.

Staff were supported in their role with an induction and training. People lived in an environment which was suitable to meet their needs. People could choose their meals and were supported to eat and drink. People were supported to maintain their health and well-being.

People had choice and control of their lives and staff were aware of how to support them in the least restrictive way possible; the policies and systems in the service were supportive of this practice.

People were supported by caring staff that protected their privacy and dignity. People were supported to make choices and their independence was promoted. Peoples communication needs were assessed and planned for.

People had their preferences understood by staff. People were clear about how to make a complaint and these were responded to.

Notifications were submitted as required and the registered manager understood their responsibilities. People and their relatives were engaged in the service.

This inspection took place on 26 July 2017 and was unannounced. Copperdown Residential Care Home provides residential care for up to 29 older people, some of whom may be living with dementia. There were 29 people resident at the time of our inspection. Our previous inspection was carried out on 7 October 2015 and the service was rated Good.

The service had a registered manager. 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.

Medicine management systems were not always safe as medicines were not stored or audited effectively. Advice was needed for how some medicines were prescribed to ensure these were safely administered to people. The staffing levels had been reviewed to meet people’s support care needs in the afternoon but we saw staff were not always available to ensure people’s safety at other times during the day. Where people needed help to make some important decisions about their care, it was not always clear how each decision was reached. Where people were subject to new restrictions on their freedom to keep them safe, these had not been identified to ensure these were lawful. People had mixed views about how they were supported to engage with activities that interested them. Quality assurance systems were in place, however these were not always effective as they had not identified these concerns.

Staff understood their role in protecting people from the risk harm or abuse and the actions they needed to take if they had concerns. People were confident that the staff supported them well and had received training to develop the skills they needed to provide their care. Recruitment checks were made before staff employment to confirm they were of good character and suitable to work in a care environment.

People were supported by a consistent staff team that knew them well and promoted their independence. People’s needs were assessed and support plans where developed with them and their representatives to enable them to be supported in their preferred way. There were regular reviews of people’s care to ensure it accurately reflected how they wanted to be supported.

People were happy with the quality of the food and could have food and drinks that they enjoyed throughout the day. People received support from health care professionals to help ensure their well-being was maintained. Health concerns were monitored to ensure people received specialist health care intervention when this was needed.

Staff were kind and caring when supporting people and knew their likes and dislikes. People’s privacy was respected and the staff made visitors feel welcome and were approachable. There were processes in place for people to raise concerns and express their views and opinions about the service provided.

We found a number of breaches of 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 the report.

Following the inspection in September 2013 the manager sent us evidence of what they had done to ensure that the concerns we had raised had been dealt with. The manager had completed this in a timely manner to ensure that people's immediate needs were met. We spoke with staff and they told us that it was now easier to meet people's needs as they had the equipment and staffing they required.

We have conducted a desk top review and found that people's care and welfare needs were being met through an increase in staffing and up to date assessments of people's needs being completed.

We looked to see if people who used the service consented to their care, treatment and support. We found that the service had systems in place to show that people or their representatives had been involved in consenting to their care.

We looked at care records, spoke to people who used the service and observed their care being delivered. We had concerns that the service was not able to meet some people's assessed needs.

We found that the equipment used to support people in Copperdown was properly maintained and suitable for its purpose.

We found that the service was following the correct recruitment procedures when they employed new staff.

We had concerns that there was insufficient staffing to meet people's individual needs at night.

The service had a complaints procedure for people who used the service or their relatives to use if they felt the need to complain about the service.

We were supported throughout the day by the deputy manager and the senior carer.

People who used the service told us they liked living at Copperdown Care Home. One person told us, "It's lovely here. They are very kind to me". People spoke very highly of the deputy manager and senior carer.

We observed that people seemed happy and relaxed and encouraged to be as independent as possible. One person had chosen to stay in their room for lunch and staff respected this choice. Care needs were met appropriately and discreetly.

Staff we spoke with spoke respectfully about the people that used the service. They told us they were happy working at Copperdown and felt supported and had received training to complete their role.

The service had a comprehensive safeguarding policy and we saw evidence of the appropriate use of the policy.

Quality monitoring was ongoing and took the form of several audits and questionnaires. We saw that people that used the service were continually being involved in having their say about the quality of service they received.