Background to this inspection
Updated
22 July 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was undertaken by one inspector.
Service and service type
Copperfields Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.
During the inspection
We spoke with three people who lived in the service and four relatives about their experiences of the care provided. We spoke with four members of staff including the registered manager, a senior care worker, the cook and the provider. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included five peoples’ care records and multiple medication records. We looked at five staff files in relation to recruitment and supervision. A variety of records relating to the management of the service including audits, policies and procedures were reviewed.
After the inspection
We continued to see clarification from the provider to validate the evidence found. We looked at training records, staff rotas, handover meeting notes and health and safety information.
Updated
22 July 2021
About the service
Copperfields Residential Home is a residential care home providing accommodation and personal care for up to 20 people. The service supports older people and people living with dementia. The accommodation is provided across two floors in one building. There were 10 people living in the service at the time of the inspection.
People’s experience of using this service and what we found
Quality assurance processes and audits were not always robust enough to identify shortfalls and to continually monitor, evaluate and improve the service.
Some environmental health and safety checks had not been completed in a timely manner and records of health and safety checks were inconsistent and lacked clarity. For example, emergency lighting, water temperatures and fire training were not up to date.
Staff were not always recruited safely. For example, employment history and reference checks were not documented in every case. However, most of the time there were enough staff to support people safely.
Most risk assessments and care plans were completed accurately and contained enough information for people to provide safe care. A stair gate had been fitted to prevent unauthorised access to the basement and to minimise risks to people. This was a recommendation following the last inspection.
People told us they felt safe in the service and relatives agreed. One relative said, “They genuinely want the best for my mum.”
Medicines were managed safely in line with current guidance. People received their medicines as prescribed by people who were trained to do so. Medicines were ordered, stored and disposed of safely.
People and their relatives were involved in decisions about their care. Relatives had been invited to meetings to discuss and agree care plans. Relatives had been kept informed of any changes by the staff at the service.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
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
The last rating for this service was requires improvement (published 01 December 2020) and there was a breach of regulations. The provider completed an action plan after the last inspection to show us what they would do and by when to improve. At this inspection enough improvement had not been sustained and the provider was still in breach of regulations. This service remains rated requires improvement. This service has been requires improvement for the last four consecutive inspections.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 8 January 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve staffing and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements.
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 remains the same. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe, responsive and well-led sections of this full report.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Copperfields Residential Home on our website at www.cqc.org.uk.
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 have identified breaches in relation to good governance at this inspection. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan for 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.