Copthorne Complete Home Care Limited

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We identified 2 breaches of the legal regulations. The assessment of people’s needs was still not person-centred or in line with current good practice guidance. People’s rights around consent were not considered in planning how they wanted their care delivered. However, people felt they had the support they needed.

This service scored 33 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives told us their family member’s individual needs had been assessed and staff understood these needs. However, one relative told us, “There is a file, but I don’t know really what is in there, they (staff) do what I need them to do.” People’s communication needs were assessed; however, the plans were generic and did not maximise their independence or detail how staff should effectively communicate with them. The communication plans were not correct and did not detail how the person actually communicated. One relative confirmed how their family member communicated, which was totally different to their communication plan and said, “(I) don’t know if this is recorded anywhere.” This placed people at risk of not being able to be involved in their own care.

Although staff had been told by the registered manager how to support people, information was missing from care plans regarding health, care, wellbeing, and communication needs. Staff did not have the information they needed to manage people’s health needs such as epilepsy, dementia, expressing agitation, medicines, skin conditions and daily routines. The registered manager did not respond to people’s changing needs and did not update their care plans to reflect these changes.

The provider did not use any assessment tools to identify or assess people's needs. The provider had not assessed people’s skin integrity despite supporting people with skin conditions. The registered manager could not evidence people were involved in decisions about their care and support. Despite people’s relatives telling us their family members’ needs were met, we found gaps in the assessment of needs, such as assessing skin integrity, risk of falls, medicines support, capacity to consent and communication needs which failed to be assessed or planned for. The provider did not support peoples’ understanding and involvement in the care and support they received. Peoples’ capacity and ability to consent to their own care and support was not considered to enable them to be actively involved in the development of their own care and support. This put people at the risk of being excluded from making decisions about their care and support.

Relatives of those receiving care felt staff met people’s needs and had a safe standard of practice.

People were put at risk of not having their needs met because staff knowledge of best practice guidance and standards was poor. When asked about 1 person’s risk of falls the registered manager told us they would score it as 0 to 1. However, they could not explain what this meant or if this score indicated a high risk or low risk of falls. The registered manager also told us skin integrity assessment tools were not needed in the community as they provided care in people’s own homes and not a hospital. The registered manager failed to understand the need for people’s care to be delivered in line with legislation and evidence based good practice.

The provider failed to complete accurate and full assessments of people’s needs in line with good practice standards. There was no use of recognised best practice guidance, standards or assessment tools for planning and delivering care including risk of falls or skin breakdown. Despite 1 person having topical creams applied, the provider had not used any skin assessment tools to assess their risk of skin breakdown.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

Relatives felt the registered manager sought their opinions and valued their feedback regarding consent.

Staff had received training in the Mental Capacity Act 2005 (MCA) but did not understand the implications of this on their role. The registered manager did not understand the application of the MCA. Despite attending training, they did not know the need for completing a capacity assessment on a person and did not know they could do this themselves. This lack of knowledge put people at risk of not having their rights upheld and receiving care which was not personal to their needs.

The provider did not have safe and effective processes in place to ensure people’s consent was lawfully obtained. No capacity assessments had been completed for people and we found conflicting information in care plans. The provider failed to ensure they had safe and effective processes in place to confirm those consenting on behalf of people had the legal authority to do so. The registered manager had sought family consent for 1 person. However, they had not first established if the person had the capacity to consent to their own care rather than the family. This excluded people from decisions and put them at risk of harm by having their individual rights abused.