Inspection on 30/06/10 for Coatham Nursing Home

This inspection was carried out on 30th June 2010.

CQC found this care home to be providing an Adequate 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Coatham Nursing Home 07/07/09

Coatham Nursing Home 10/07/08

Coatham Nursing Home 31/07/07

Similar services:

Ashlea Mews Residential Home

Eastwood

West Lodge

Arran House

Avenue Community Nursing Home

Cosin Lodge

Farmborough Court

Cragston Court

Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Random inspection report Care homes for adults (18-65 years) Name: Address: Coatham Nursing Home Coatham Road Redcar Cleveland TS10 1RA one star adequate service 08/07/2009 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: Andrea Goodall Date: 3 0 0 6 2 0 1 0 Information about the care home Name of care home: Address: Coatham Nursing Home Coatham Road Redcar Cleveland TS10 1RA 01642482208 Telephone number: Fax number: Email address: Provider web address: vinodhukkeri@yahoo.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mr Peter John Joy Type of registration: Number of places registered: Conditions of registration: Category(ies) : Gradestone Limited care home 21 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Conditions of registration: Date of last inspection Brief description of the care home 21 0 8 0 7 2 0 0 9 Coatham Road is a 21-bedded care home for Adults aged 18-65 who has a mental disorder. The home is a converted property on three floors with the majority of bedrooms being on the first and second floors. There are fifteen single bedrooms and three double bedrooms. On the ground floor there are two lounges, as well as the kitchen and dining room. The home is situated near to Redcar town centre and is within short walking distance from the beach. It has easy access to local amenities and is directly on a bus route. Many of the Residents have lived in the home for a number of years. The home charges fees in the range #354 to #500 per week. Care Homes for Adults (18-65 years) Page 2 of 13 What we found: Before the visit we looked at information we have received since the last key inspection visit on 2nd June 2009. We looked at any changes to how the home is run. We asked the provider for their view of how well they care for people in their AQAA (an annual quality assurance assessment) but this document was not received. We looked at any complaints or concerns about the home and how the provider has dealt with these. We made an unannounced visit to the home on 30th June 2010. The inspection was carried out by two inspectors over 5 hours. During the visit we talked with people who use the service, the manager and staff. We joined residents for a lunch time meal. We looked at how staff support the people who live here. We looked at information about the people who use the service and how well their needs are met. We looked around parts of the accommodation. We looked at staff rotas and staff training records to see if there are sufficient staff who are suitably trained. We looked at the care files of five residents. Care plans are records that are used by all care services to show what sort of help each person needs and how staff will provide that care. For example some people need support with activities, self-harm, diabetes, anxiety, or aggressive behaviour. We looked at the care plans for five people. There had been no monthly reviews of care plans from September 2009 to April 2010. In this way care plans are not being kept under review to show any change in needs. We looked at risk assessment records about peoples health care needs. We found there are many shortfalls, as assessments were incomplete or had not been reviewed for many months. For example nutrition assessments for someone with diabetes had not been completed between September 2009 to December 2009, and then not completed between February 2010 to May 2010. It was evident from weight records that this person has gained a significant amount of weight over the past year but the nutrition records are incomplete. Observations records had not been completed since February 2010. For another person observation and monitoring of blood pressure and weight had not been recorded since February 2010. The assessment showed that this person also requires prompts with personal hygiene due to potential self-neglect. However the monthly hygiene records (eg to show when people had a bath, shower or body wash) were blank. In some files the moving & assisting assessments were blank. In some files there were assessment records for risk of aggressive behaviour but these had not been completed for many months over the past year, despite a number of incidents involving aggressive behaviour. It was a requirement of the last inspection that incidents that impact on the well-being of residents must be reported to CQC (these are called regulation 37 notifications). In discussing this requirement the manager stated that there had been no incidents at the home since the last inspection. However we examined incident and accidents reports which clearly demonstrated that there had been several events that should have been notified to CQC. These included an accident that meant a resident had to go to Accident & Emergency; an overdose by a resident; and four occasions where people had physically assaulted another resident or a member of staff. In this way the home has failed to meet the previous requirement. Care Homes for Adults (18-65 years) Page 3 of 13 It was a requirement of the last inspection that any incidents of suspected abuse must be reported to the local authority via safeguarding adults procedures. However the incident records at the home demonstrate that there have been at least four occasions where residents have physically assaulted another resident or staff and these incident should have been reported to the local authority safeguarding adults team. Staff training records show that six of the twelve staff have had prior training in Abuse, however this does not include the local authority safeguarding adults protocols. It is also clear that staff, including the manager, do not recognise that incidents between residents could constitute abuse. In this way the home has failed to meet the previous requirement. In discussions people said that they like living here and there was clearly a friendly interaction between staff and residents. It was clear from discussions that permanent staff have a good understanding of individual peoples needs. People spend time in different parts of the house as they choose, and some people go out independently. The lunchtime meal was hearty, home made food - either beef goulash or steak & kidney pie with mashed potatoes and two vegetables. Written menus and discussions with people confirmed that people have a choice of two main dishes. Overall people made positive comments about the quality and amount of food they are offered, although some people felt that the vegetables were cold today. A number of recommendations were made at the last inspection about the state of the environment. These included broken, stained chairs, and carpets in a poor state. Since the last inspection a relative has donated two good quality sofas for the two lounges. However the carpet to one lounge remains pitted with cigarette burns. The corridor carpet from the dining room to the rear of the home is badly stained. The flooring to a ground floor toilet is perished, badly stained and very odorous. These premises shortfalls do not uphold the dignity or respect of the people who live here. Inspectors were very concerned about the low number of staff employed at the home. There are currently only twelve staff on the staff rota, including a bank staff. One care staff is on maternity leave, and one nursing staff has recently been dismissed. The home currently has vacancies for a RMN (registered mental health nurse), two care assistants, a full time cook and a domestic staff. As a result there are no daytime nursing staff employed so the manager is having to cover the role of RMN, and is carrying out between 60-84 hours a week, which is unacceptable. The home is having to use bank and agency staff to cover care staff shortfalls. The domestic staff and a senior staff are having to cover catering duties. On the day of this inspection the manager was acting as RMN, the senior and an agency staff were providing care support, and the domestic staff was also covering the catering duties. There are no training records available in the home for five of the twelve staff, including both RMNs on night duties, a bank RMN, and two care assistants who cover most of the daytime duties. In this way the home is unable to demonstrate that those staff have sufficient and suitable training to carry out the jobs that they perform, and this potentially places people at risk. A requirement was made at the last inspection about the lack of training for staff in health & safety, COSHH, first aid and safeguarding adults. However training records Care Homes for Adults (18-65 years) Page 4 of 13 showed that there has been no training for staff in these areas since the last inspection and in discussions the manager confirmed this. Of the training records that exist (for seven of the staff including the maintenance staff) only one member of staff has first aid training. The training records indicate that no staff have had training in COSHH, including domestic staff. One person who lives here is now immobile and uses a wheelchair. Staff use a hoist to transfer the person. However training records indicate that none of the staff have had any training in moving & assisting, which indicates that they are not trained in current safe practices and techniques. The manager stated that five staff have had this training, but there are no records to demonstrate this, and those five staff do not cover all the shifts over the course of a week. In this way staff are untrained and may be using unsafe practices when supporting a person with their significant mobility needs. It was a requirement of the last inspection that the provider should seek peoples views as part of the homes quality assurance processes, and must make a summary report available to the people who use this service. The manager commented that there is no report in the home of last years survey. The manager stated that recent surveys have been completed by the residents, relatives and staff but the results have not yet been collated or published. It was also a requirement of the last inspection that the provider must complete a written report of the operations of the home on at least a monthly basis (these are called regulation 26 reports). This is to make sure that the provider reviews, on a not less than monthly basis, whether the home is being managed effectively and in the best interests of the people who live here. However at the time of this visit there was only one regulation 26 report (dated February 2010) available in the home. In this way the home is being managed in a very poor way. The manager has no time to carry out management tasks, including staff supervision, review of care records, appointment of new staff or staff training. The provider is failing to carrying out his legal responsibilities to review the service and to ensure that it is operated in a satisfactory way. Inspectors were also extremely concerned about the financial viability of the home. During this visit the manager stated that there was a recent threat of disconnection of the electrical supply due to non-payment of bills. It was also indicated that the home has had final demands from grocery suppliers and that two nursing agencies no longer supply agency staff due to significant unpaid bills. What the care home does well: What they could do better: Care Homes for Adults (18-65 years) Page 5 of 13 Five requirements from the previous inspection are still outstanding.There are also a further six requirements made at this inspection. Care plans must be kept under review to show any change in individual needs. All incidents which affect the well being of people who use the service must be reported to the CQC via a regulation 37 notice. Any incidents of suspected abuse must be processed through safeguarding people procedures. The odorous, badly stained flooring to the ground floor toilet must be replaced. The home must employ sufficient staff to meet the number and needs of the people who live here. Staff must receive training in Health and Safety, COSHH, First Aid and Safeguarding People. All staff must have up to date training in moving and assisting. Training records should be in place for each of the staff. Training records should include all training attended by each staff member. The results of the quality assurance surveys carried out by the provider must be available to the people who use the service and the commission. When the registered provider visits the home monthly to check the operations of the service he must complete a written report (regulation 26), and a copies of these reports must be available in the home. The provider must supply to CQC up to date annual accounts of the care home certified by an accountant to demonstrate whether the home is financially viable. 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 Adults (18-65 years) Page 6 of 13 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 19 12 All incidents which affect the 07/10/2009 well being of people who use the service must be reported via a regulation 37 notice or processed through safeguarding people. This is required to safeguard the people who use the service. 2 23 13 Incidents of suspected abuse 07/10/2009 must be processed through safeguarding people. This is required to safeguard the people who use the service. 3 35 18 Staff must receive training in 09/10/2009 Health and Safety, COSHH, First Aid and Safeguarding People. This is required to safeguard the people who use the service. 4 38 24 The results of the quality assurance surveys, carried out by the provider must be available to the people who use the service and the commission. This is to ensure that the 07/10/2009 Care Homes for Adults (18-65 years) Page 7 of 13 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 views of people who use the service are listened to and acted upon. 5 39 26 When the registered provider 07/10/2009 visits the home monthly, and talks to staff and people who use the service he must complete a written report (regulation 26), a copy of which should be in the home. This will ensure that the home is being managed effectively and ensuring the best interests of people living there. Care Homes for Adults (18-65 years) Page 8 of 13 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 6 15 Care plans must be kept under review to show any change in individual needs. This is to ensure that any changes in need are recorded and acted on so that people receive the right support. 23/08/2010 2 19 13 Risk assessments about individual peoples health needs must be in place, updated to reflect their changing needs, and kept under review. This is to ensure service users are protected from risk of harm. 23/08/2010 3 19 37 All incidents which affect the 23/08/2010 well being of people who use the service must be reported to the CQC via a regulation 37 notice. This is required to safeguard the people who use the service. 4 23 13 Any incidents of suspected 23/08/2010 Page 9 of 13 Care Homes for Adults (18-65 years) 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 abuse must be processed through safeguarding people procedures. This is required to safeguard the people who use the service. 5 24 23 The odorous, badly stained flooring to the ground floor toilet must be replaced. This is to ensure that people live in a reasonable standard of accommodation. 6 33 18 The home must employ 23/08/2010 suitable staff in sufficient numbers to meet the number and needs of the people who live here. This is to ensure that the people who live here are supported with their needs at all times. 7 35 18 All staff must have up to date training in moving & assisting. This is to ensure that staff are trained to use safe working practices when supporting the mobility needs of a resident. 8 35 18 Staff must receive training in 23/08/2010 Health and Safety, COSHH, First Aid and Safeguarding People. This is to ensure that staff are trained in the duties that Care Homes for Adults (18-65 years) Page 10 of 13 11/10/2010 11/10/2010 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 they perform. 9 39 24 The results of the quality 23/08/2010 assurance surveys, carried out by the provider must be available to the people who use the service and the CQC. This is to ensure that the views of people who use the service are listened to and acted on. 10 39 26 When the registered provider 23/08/2010 visits the home monthly, and talks to staff and people who use the service he must complete a written report (regulation 26), a copy of which should be in the home. This is to ensure that the home is being managed effectively and in the best interests of people who live here. 11 43 25 The provider must supply to 23/08/2010 CQC up to date annual accounts of the care home certified by an accountant; a reference from a bank expressing an opinion as to the registered providers financial standing; and information about the financial resources of the home. This is to detemine whether the home is being carried on in a way that is financially viable. Care Homes for Adults (18-65 years) Page 11 of 13 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 1 2 3 5 24 25 Consideration should be given to provision of an accessible toilet for people who mobility needs. There should be fitted privacy screens in shared bedrooms. The badly burnt carpet in the lounge shoud be replaced, and the stained corridor carpet should be cleaned or replaced. There should be a training and development plans for each staff member. Training records should include all training attended by each staff member. There must be sufficient supernumerary time for the manager to carry out managerial, supervisory and administrative tasks. 4 30 5 37 Care Homes for Adults (18-65 years) Page 12 of 13 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 Adults (18-65 years) 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 Adults (18-65 years) Page 13 of 13 - 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!