This inspection took place on 26 September 2018 and was unannounced. At the last inspection completed on 26 July 2017 we rated the service Requires Improvement.

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.

This inspection took place on 7 October 2015 and was unannounced.

The service was registered to provide accommodation and personal care for up to 29 people. People who used the service had physical health needs and/or were living with dementia. At the time of our inspection 29 people were using the service.

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.

At the last inspection on 6 May 2014, we asked the provider to take action to make improvements because robust systems were not in place to ensure people were protected from the risks associated with medicines. This action had been completed and improvements had been made.

Medicines were safely managed, stored and administered to ensure that people got their medicines as prescribed. There were enough staff to people’s needs. People told us and we saw that requests for support were responded to promptly by staff who had been checked to ensure they were suitable to work with the people who used the service.

People felt safe and staff knew how to protect people from avoidable harm and abuse. People’s risks were assessed and managed to help keep them safe and we saw that care was delivered in line with agreed plans.

Staff were suitably trained to meet people’s needs and were supported and supervised by the registered manager. Staff understood how to support people to make decisions and when they were unable to do this, support was provided in line with current legislation and guidance.

People with provided with enough food and drink to maintain a healthy diet. People had choices about their food and drinks and were provided with specialist support when required to ensure their nutritional needs were met. People’s health was monitored and access to healthcare professionals was arranged promptly when required.

People were treated with kindness and compassion and they were happy with the care they received. People were encouraged to make choices about their care and their privacy and dignity was respected.

People had support to meet their individual needs and preferences by staff who knew them well. Care plans were detailed and personal so that staff had the information they needed to be able to provide support to meet needs and requirements.

People knew how to complain and staff knew how to respond to complaints. A complaints procedure was in place though no formal complaints had been received. People and their relatives were encouraged to give feedback on the care provided. The registered manager and provider responded to feedback and changes were made to improve the quality of the service provided.

The registered manager understood the conditions of registration with us. We saw that systems were in place to monitor quality and that the registered manager analysed information and took actions to make improvements when required. There was a positive and homely atmosphere at the service and people felt the registered manager was approachable and responsive.

We inspected Copperdown residential home on a planned unannounced inspection which meant the service did not know we were coming.

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 visited Copperdown Care Home on a planned unannounced inspection which meant the service did not know we were coming.

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.

We visited Copperdown to look for improvements in the areas where we had concerns at a previous visit.

At the previous visit people had told us that they liked living at the home. They said they liked the staff and that staff were always there to provide them with any support they needed.

Non compliance had been identified in Outcome 7 with regard to the reporting of safeguarding and the completion and review of some risk assessments. Staff training and knowledge of safeguarding was also found to be in need of update. Non compliance had also been identified in Outcome 21 with regards to care records being incomplete, assessments not being recorded and monitored and accident reporting not following the legal procedures.

At this follow up visit compliance had been achieved in both outcomes.

The service had provided us with an action plan following the previous visit to demonstrate improvements and compliance.

People told us they were happy living at the home. They said they got on with the staff. Comments included, "They are lovely and caring", and "They make it like home".

People said they had their health and personal care needs met. They saw the doctor when they were ill. The optician, dentist and chiropodist visited them at the home. Staff knew about people's needs and treated people in a respectful way.

The staff organised social activities for people to do in the home. These included gentle exercise, musical entertainment and board games. There were no arrangements for the home to take people out of the home for activities or social events.

Each person had a plan of care but these were very limited and did not include all areas of need and did not show how people liked their care providing. Records were not in place to show that people's needs and any risks were being assessed or monitored.