The inspection took place on 19 and 20 March 2015 and was unannounced. Copper Beech provides residential care for up to four people with learning disabilities and autism. At the time of our inspection three people were living in the home.
The home is on a single level. Self-contained flats provided independent accommodation for each person, with additional communal facilities including a kitchen and lounge. This enabled people to join in with group activities and socialise together. Copper Beech is one of 13 homes in Ravenswood Village, managed by the provider for people with learning disabilities, autism and physical disabilities. Community facilities, including a swimming pool, café and stables, are located within the Village for people’s use.
The home had a registered manager. 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. At the time of our inspection, the registered manager was on planned long term leave. The provider had informed us of interim measures to manage the home. The deputy manager had been temporarily promoted to cover management duties, and is referred to as the manager within this report.
During this inspection we checked whether the provider had taken action to address the regulatory breach we found during our inspection in July 2013. This related to the poor state of the home, which required refurbishment to address the issues identified. The provider told us they would complete the actions required by the end of December 2014, as there was a planned conversion to provide people with individual flats within the home. Building work had been delayed, but was in the final stages to address minor snagging issues at the time of our inspection. The actions required to meet the concerns identified at our inspection in July 2013 had been completed.
Although the Medicines Administration Records (MARs) documented that people received and took their prescribed medicines, these were not always completed promptly once medicines had been administered. Stock checks of medicines held in the home did not always correlate with people’s MARs. Inaccurate stock checks and records meant there was a risk that sufficient medicines may not be available to meet people’s prescribed doses.
Medicines were administered, stored and disposed of safely. Equipment was checked and serviced in accordance with manufacturers’ guidance to ensure people, staff and others were not placed at risk of harm. However, records of monitoring checks and audits within the home, such as recording and reviewing people’s weights, had not always been fully documented. Risks to people from these omissions were reduced because people received one to one support throughout the day. Staff were observant and caring, and understood the actions required to protect people from harm.
People were supported by sufficient staff who were trained to ensure they received the care they required. The manager had identified that some training required refreshing, and had arranged time for staff to attend to this. People’s specific health, emotional and dietary needs had been identified, and staff followed the provider’s guidance to ensure these needs were met effectively. Robust recruitment checks ensured people were supported by staff suitable for the role. Communication within the home and liaison with health professionals meant people’s needs and preferences were appropriately supported.
People’s rights and wishes were promoted through effective implementation of the Mental Capacity Act 2005. Staff understood the actions to take if a person was assessed as lacking the mental capacity to make an informed decision. The manager understood and followed the requirements of the Deprivation of Liberty Safeguards.
Relatives described staff as caring and loving. We observed staff treated people with respect and affection. They took care to promote people’s dignity and privacy. They listened to people’s comments, and supported them as they wished. Where people were unable to verbally communicate their wishes, staff understood the communication methods people used to indicate their preferences.
People’s needs were regularly reviewed with them, and six monthly reviews held with them and their relatives. Risks to people’s health and wellbeing were identified and assessed to ensure people and others were protected from potential harm. People attended and participated in a range of activities within the home, Village environment and wider community. These activities were specific to each person’s preferences. People and their relatives were regularly asked for their views of the home and the care people received, and these views influenced changes to people’s support plans.
Staff told us they felt supported, and could approach managers and the provider for advice at any time of day or night. Effective communication and discussion of issues ensured that learning was shared, and drove improvements to people’s daily lives in the home. The provider’s values were reflected in the culture of the home, such as providing person-centred care, and learning from feedback to ensure people experienced a high quality of care.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to 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 this report.