This is the latest available inspection report for this service, carried out on 9th June 2010.
CQC found this care home to be providing an Good service.
The inspector found there to be outstanding requirements from the previous inspection
report. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.
Random inspection report
Care homes for older people
Name: Address: Littlecoates House Care Home Littlecoates Road Grimsby North East Lincs DN34 4NN two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Rob Padwick Date: 0 9 0 6 2 0 1 0 Information about the care home
Name of care home: Address: Littlecoates House Care Home Littlecoates Road Grimsby North East Lincs DN34 4NN 01472343833 01472354743 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Cherry Sykes Type of registration: Number of places registered: Conditions of registration: Category(ies) : Littlecoates House Care Home Ltd care home 46 Number of places (if applicable): Under 65 Over 65 0 46 dementia old age, not falling within any other category Conditions of registration: 16 0 The maximum number of service users who can be accommodated is: 46 The registered person may provide the following category of service only: Care home only - Code PC Tto service users of the following gender: Either Whose primary care needs on admission ot the home are within the following categories Old age, not falling within any other category - Code OP maximum number of places 46 Dementia - Code DE, maximum number of places 16 Date of last inspection Care Homes for Older People Page 2 of 9 Brief description of the care home Littlecoates House is situated on the outskirts of Grimsby. It is close to local amenities including shops, post-office, doctors surgeries, chemist, golf club, public houses and Grimsby college. The accommodation for the people living in the home is provided over one storey. All entrances, fire exits, and inner doors are wide enough for wheelchair users and all of the bedrooms have en-suite facilities. Car parking is provided to the rear of the building, and there is a risk assessment covering the building and the grounds. The gardens are well kept and there is an enclosed patio area in the centre of the home. This has recently been developed to include an enclosed garden. Littlecoates House is registered for the care of Older People. This includes up to 16 placements for elderly service users with dementia related needs. Details of the current fees are available from the home on request. The management have included a top up fee for all residents except respite individuals following consultation with people using the service and their relatives. Information about the home and its service can be found in the statement of purpose and service user guide, both these documents are available from the manager of the home. The latest inspection report for the home is available from the manager on request. Care Homes for Older People Page 3 of 9 What we found:
This random inspection was carried out on 17th February 2010 and the 9th June 2010 and was undertaken by Two Regulatory Inspectors Mr Rob Padwick and Ms Kate Emmerson. The reason for the inspection visit was to check outcomes for people using the service and the impact of concerns about the financial viability of the service which were raised by North East Lincolnshire Care Trust Plus. On our last Key Inspection visit to the home we found that people using the service experience good quality outcomes but made requirements to improve the recording of medicines and for an up to date record of complaints to be maintained by the service. Since then we subsequently received evidence of action taken in respect of these requirements, we therefore did not check these specifically on this occasion. We will follow this up on our next visit to the home. Since we last visited the service we were informed of a reduction of staffing numbers which we wrote to the provider about. We were told staffing levels would change according to the fluctuating numbers and dependencies of people using the service, as a result of a reduction in occupancy levels but that these were being closely monitored. In October 2009 we were informed about concerns over staffing arrangements following the late payment of wages which we also wrote to the provider about. We were subsequently reassured that staffing levels would be appropriately maintained, together with details about the financial viability of the company. The Local Authority has continued to regularly monitor the service following receipt of the above concerns, to ensure people using the service are appropriately safeguarded from harm. Failures to be paid appropriately have continued to be experienced by staff in the home and we were contacted recently by the Local Authority, following further concerns about the financial viability of the service. We observed people using the service looking clean and well cared for with staff interacting with them in a friendly and positive manner. The local Authority has been monitoring the service closely in recent months and reviewing the care provided to ensure the home is continuing to meet the needs of people using the service. Notifications about significant events have indicated the service continues to take appropriate action regarding identified health concerns and that medication administered in the home is closely monitored with action taken when this is needed. We observed people having a lunch of a good sized portions of home cooked chicken casserole and vegetables followed by sponge and custard. People living in the home told us they generally enjoyed their meals and were able to make choices about these. The cook told us that menus had been modified following consultation with people using the service but indicated some problems associated with non payment of food bills sometimes occurred. We were told the manager uses a credit card to cover emergency payments, but that this sometimes didnt work straight away. On the day of this visit the cook had needed to go out to buy bread as the normal order had been delayed due to difficulty in getting a payment through. Whilst there was evidence the environment was generally being maintained to ensure
Care Homes for Older People Page 4 of 9 people using the service live in a home that is comfortable and safe and well maintained, the building would still benefit from a general upgrade as some areas looked shabby and some door paint work was scratched. The home was free from offensive smells and was generally clean and tidy; however some surface areas were a bit sticky to the touch. We saw evidence of appropriate servicing of equipment and staff told us there were generally sufficient aids available, but we were told that a hoist had needed to be borrowed from a sister home following one breaking down although an emergency review had been held to obtain a new one from Social Services. There were six staff plus the manager on duty and staff told us these were sufficient to meet the needs of the twenty seven people living in the home and were normal for the service. Staff rotas indicated shift patterns were appropriately covered but that three staff were currently off sick, which the manager told us was attributed to stress and with agency staff used to cover these shortfalls. The manager told us she was hoping to employ more staff following a recent job advert. Whilst staff told us they loved working in the home they reported low morale and staff sickness, which they indicated was associated with continued uncertainties regarding them not being paid in a regular and timely manner. On the day of this visit, a wage payment had been further delayed and a senior member of staff told us they were currently awaiting Criminal Records Bureau clearance before handing in their resignation and starting with another job and we were told about others who were also in a similar position. The manager told us the company had offered a £100 hardship payment in lieu of late payment of wages, but that this was insufficient to pay staff for their day to day needs and that she was making payments to enable them to get into work from fees that had been paid for the home. A new member of staff indicated appropriate recruitment checks continue to be completed to ensure staff are safe to work with people living in the home and we were told they had received induction training to ensure they had the skills needed to meet the needs of people using the service. When we last visited the home we indicated that whilst management systems were in place to support the running of the service, there was some evidence the manager would benefit from further support as some information was at times hard to find. Since then there had been loss of administrative support for the service and we observed office systems continued to be weak with the manager not always fully following company procedures appropriately. The responsible individual who was visiting on the day of our visit told us that owing to problems elsewhere in the company, she had not been able to provide ongoing support but indicated she now intended to rectify this and would be making more regular visits to the home. Whilst the manager told us she attended regular management meetings, communication between other aspects of the organisation were identified as poor. We were told staff from headquarters had previously visited at late notice and without the managers knowledge, to inform staff of further problems associated with payment of their wages and that communications about this had previously been received by fax without prior warning. Despite cash flow problems identified by the company following a change in banking arrangements for the home, the responsible individual was unaware of money received in payment of fees that should have been banked and was now being used by to pay for emergency staff transport costs. The manager told us that delays in payments for some services received had resulted in a credit card issued to her to make emergency payments with, however the records maintained for the cards use were inadequate and insufficiently robust and she was unable to identify its outstanding balance.
Care Homes for Older People Page 5 of 9 What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 9 13(2) The responsible person must 25/06/2009 make sure accurate records of medication are kept and that people living in the home receive these as prescribed. This is to ensure they are safeguarded from potential harm. 2 16 17 (2) 11 The Registered Person must 25/08/2009 ensure a record of all complaints made about the service is available to ensure the concerns of people living in the home can be followed up and their interests are safeguarded. Care Homes for Older People Page 7 of 9 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 34 12 The Registered Provider must 22/07/2010 maintain good personal and professional relationships with staff and people using the service. This is to ensure their welfare is promoted. 2 34 25 The Registered Provider must 31/07/2010 ensure accurate financial records are maintained for the home. This is to ensure the service will be financially viable for the purpose of achieving its aims and objectives and the welfare of people living in the home are promoted and protected. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 8 of 9 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 9 of 9 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
