CQC report explained · a nursing home
What the CQC found at Coppice Court Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Medicines were stored, administered and recorded safely. Risks such as falls, skin damage, fire and infection were assessed and managed, although some people experienced long call bell waits.
- Effective?
- Good
- Staff had the skills and training to support people, including people living with dementia. People received suitable food, help with eating and drinking, and support from health professionals.
- Caring?
- Good
- People and relatives said staff were kind, respectful and compassionate. Staff knew people's preferences, histories and choices, and supported privacy and independence.
- Responsive?
- Good
- Care plans reflected people's individual needs, preferences and interests. People were supported with activities, communication, complaints and end of life care.
- Well-led?
- Requires improvement
- Management systems had improved, but leaders had not used all available feedback to improve the service. Staffing concerns and slow call bell responses had been identified but not fully acted on.
What inspectors found, June 2019
Coppice Court Care Home was rated Good overall; inspectors found kind, personalised care, but leadership and response times needed improvement.
This was an unannounced follow-up inspection, with visits on 18 and 24 April 2019. Inspectors reviewed records, medicines, care plans, staffing and complaints. They spoke with people living at the home, visitors, staff and health professionals, and observed care.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found that medicines, risk management, staff training, nutrition, healthcare support and personalised care had improved since the previous inspection. People were generally described as safe, well cared for and treated with kindness and respect.
The home was rated Requires Improvement for Well-led. Staff said they were rushed, sometimes missed breaks and had to cut corners. Some people waited over four minutes for call bells, with records showing waits of up to 36 minutes. Inspectors said the provider had not shown that it had acted on all this information, although they found no evidence that staffing arrangements had affected the safety of care.
Safer medicines
Inspectors found that medicines were handled safely. Staff responsible for medicines had training and competency checks, and people's medicines were reviewed each month.
“The management of medicines was safe.” from the report
Kind and respectful care
People were treated with kindness, dignity and respect. Staff understood people's individual needs, choices and histories.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Personalised activities
Activities were adapted to people's interests and abilities. People could take part in creative activities, quizzes, music, gardening and outings, or receive individual time in their rooms.
“The activities staff were highly motivated and skilled at providing activities and entertainment that were tailored to the preferences and abilities of people.” from the report
Improved staff skills
The home had reduced its reliance on agency staff and strengthened induction, training and competency checks. Dementia training was a core area for care staff.
“Staff had the knowledge, skills and experience to support people effectively.” from the report
Individual food and healthcare support
People's nutritional needs and preferences were assessed, with suitable food and help at mealtimes. Staff worked with GPs, nurses and other professionals to support people's health.
“People were supported to eat and drink a healthy balanced diet to meet their individual needs.” from the report
Long call bell waits
needs fixingSome people on the first floor often waited more than four minutes for staff to answer their call bells. The recorded analysis showed that some waits lasted up to 36 minutes.
“The analysis completed by the registered manager recorded people had waited up to 36 minutes.” from the report
Staff felt rushed
needs fixingStaff said staffing levels meant they sometimes went without breaks and cut corners to finish their work. Inspectors found no evidence that this had affected the safety of care, but it could affect people's experience.
“Staff told us the staffing levels meant they were having to go without breaks and cut corners with care to get the work completed.” from the report
Quality information not fully used
needs fixingThe provider had identified concerns through staff feedback and call bell monitoring, but had not shown that it had used all this information to improve the service.
“However, the provider had not demonstrated that all quality information had been used to improve the service.” from the report
- 01What action has been taken to reduce call bell waits, especially the waits recorded as lasting up to 36 minutes?
- 02How do you decide how many staff are needed on each floor at different times of day?
- 03How do you make sure staff can take their breaks and do not have to rush or cut corners with care?
- 04How do you collect and act on staff feedback about staffing levels?
- 05How are quality audits and call bell records reviewed, and how will families be told about improvements?
This was a follow-up inspection covering all five key questions, including the premises, care, records, medicines, staffing, complaints and quality monitoring. This explanation was written from the published report of 11 June 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, May 2018
Coppice Court Care Home is rated Requires Improvement; inspectors found kind care but concerns with medicines, staffing, care records and management.
Inspectors visited the home without notice on 15 and 20 February 2018. They spoke with people, visitors and staff, observed care and meals, and checked care plans, medicines, recruitment, complaints and quality records.
People and relatives generally felt safe and were positive about the regular staff. Inspectors found kind and respectful care, enough staff to meet daily needs, good activities, suitable food and drink, and a clean, well-maintained environment.
There were important weaknesses. Medicine instructions and records were not always clear or complete. Some agency staff lacked the skills and knowledge needed, care records did not always reflect people's changing needs, and quality checks had not found all the problems.
The overall rating was Requires Improvement. Safe, Effective, Responsive and Well-led were each rated Requires Improvement. Caring was rated Good. The report says the provider had an action plan and was working to improve the service, but legal requirements were not being met in three areas.
Kind relationships
People and relatives spoke positively about the regular staff. Inspectors saw staff being polite, caring and respectful, while supporting choice and privacy.
“People were supported by kind and caring staff. People were supported to maintain important relationships and visitors were made to feel welcome.” from the report
Activities and company
The home offered group activities and individual time. Activities were based on people's interests and helped people who spent much of their time in their rooms.
“There was a comprehensive and personalised activity programme which people enjoyed participating in.” from the report
Food and health support
People had choices of food and drink, and staff understood dietary needs. Staff worked with GPs, specialist nurses, dieticians and other health professionals.
“People had access to food and drink that met their needs and preferences.” from the report
Clean and safe environment
The building and equipment were maintained, fire arrangements were reviewed and emergency evacuation plans were available for each person.
“The environment was clean and well maintained. The provider had ensured safety checks had been maintained and equipment and facilities in the service.” from the report
Medicine records and instructions
seriousThere was no clear system for recording skin creams. Some medicines given only when needed lacked individual instructions, and staff did not always record the dose or time given.
“Systems followed did not ensure all medicines were administered safely and in a consistent way.” from the report
Agency staff skills
seriousAgency staff made up about half of the care staff and nurses. Some had minimal induction, and the provider had not assured itself that agency nurses were competent to carry out clinical duties.
“The agency staff who were deployed to maintain sufficient staffing levels at Coppice Court did not always have the skills, experience and knowledge to look after people effectively.” from the report
Care did not always reflect changing needs
seriousRecords did not always explain why people stayed in bed or show how their needs had changed. Three people who had lost significant weight had not been referred for professional advice when needed.
“This lack of responsive person centred care did not ensure people's individual needs were fully met.” from the report
Incomplete records and checks
needs fixingCare profiles, handover sheets and equipment records were incomplete or inaccurate. Quality monitoring had not identified all the areas needing improvement.
“Quality monitoring systems were not embedded into practice.” from the report
- 01How are skin creams and medicines given only when needed now recorded and checked?
- 02How do you check that agency nurses are competent to give medicines and use syringe drivers?
- 03What changes have been made to explain why people stay in bed and to review this over time?
- 04How are weight loss and changing health needs identified and referred to health professionals?
- 05Who now leads dementia care, and what changes have been made to the dementia unit?
This was an unannounced inspection of all five key areas of the home and was the first inspection since the new provider registered the service. This explanation was written from the published report of 15 May 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Coppice Court Care Home
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- June 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2018Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2017
Registered with the Care Quality Commission on 31 January 2017.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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