Inspection on 18/08/05 for Coote Lane Residential Home

This inspection was carried out on 18th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Coote Lane Residential Home 14/09/06

Coote Lane Residential Home 23/02/06

Coote Lane Residential Home 08/12/04

Coote Lane Residential Home 30/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Coote Lane Residential Home Coote Lane Lostock Hall Nr Preston, Lancashire PR5 5JE Lead Inspector Pauline Randles Unannounced 18 August 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Coote Lane Residential Home F57 F08 S49738 Coote Lane V238975 180805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Coote Lane Residential Home Address Coote Lane Lostock Hall Nr Preston Lancashire PR5 5JE 01772 312152 01772 312157 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) BLHC Coote Lane Ltd Miss Tina Maria Hill Care Home 20 Category(ies) of OP - Old age (20) registration, with number of places Coote Lane Residential Home F57 F08 S49738 Coote Lane V238975 180805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service should, at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 2. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. Date of last inspection 8 December 2004 Brief Description of the Service: Coote Lane provides residential care, for up to 20 service users, male and female who are over the age of 65. Coote Lane is a purpose built home, situated in 5 acres of land within walking distance of the village of Lostock Hall. Accommodation comprises of 20 single rooms on two floors with lift access for the 1st floor, all with the required furnishings, and a sink. Two have en suite facilities. There are also 2 bathrooms, one shower room, four separate toilets, and three lounge/quiet areas. There are also seating areas outside, accessible through patio windows from the lounge. Coote Lane Residential Home F57 F08 S49738 Coote Lane V238975 180805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection at Coote Lane was unannounced and took place over a period of six hours. There were nineteen service users living at the home on the day of inspection. The registered manager, five members of staff, six service users and a district nurse were spoken to. During the inspection the premises were viewed, records and procedures examined and activities observed. What the service does well: What has improved since the last inspection? What they could do better: Measures are in place to control the temperature of radiators at a safe level on behalf of service users. However, the required installation of radiator guards will enable service users to control the temperature in their own room, without fear of scalding, as well as improving safety throughout the premises. A signature from the person taking and recording water temperatures and from staff after reading policies and procedures would improve accountability. Coote Lane Residential Home F57 F08 S49738 Coote Lane V238975 180805 Stage 4.doc Version 1.40 Page 6 An adapted version of the interview record form would provide a more accurate account of the process. The district nurse attending a service user should be invited to contribute to the risk assessment relating to bed rails installation to give her health care opinion on the safety needs of the person concerned. Service users spoken to were not aware that they had been involved in a review of their care plan. A signature of the service user to the review would confirm their involvement and agreement to any decisions made. The appointment of an activities organiser would relieve staff time and provide a dedicated person to consult service users about the type of activities to be offered, arrange them accordingly and gain feedback. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Coote Lane Residential Home F57 F08 S49738 Coote Lane V238975 180805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Coote Lane Residential Home F57 F08 S49738 Coote Lane V238975 180805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 6 A thorough assessment of service users needs is undertaken before admission to ensure their needs can be met though the services provided by the home. EVIDENCE: The pre admission assessment procedures are extremely thorough as seen on the service user files examined and confirmed in discussion with service users. When asked if the needs he had, before coming into the home, were being met one service user said “ if I want anything and ask for it, it will happen.” Another service user had spent a previous short period in the home and had chosen to return on a permanent basis. Another service user spoken to said she “would like to stay another week, its lovely.” The husband of this service user confirmed that the manager had visited them at home and “talked to us before we came in.” Systems are in place to ensure needs are fully assessed before admission and met after admission. Coote Lane Residential Home F57 F08 S49738 Coote Lane V238975 180805 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10 There is a consistent care planning system in place that adequately informs staff about service user needs. Personal and health care needs are well met. Improvements to the care planning review process will enable greater service user awareness and participation. EVIDENCE: Files of service users hold detailed care plans that include social care needs and assessments relating to moving and handling, possible risks to safety, dietary needs and skin care. All records seen were complete and up to date. One service user described the personal care he receives as “very good” and more than one service user said it was “spot on.” Care plan reviews are held monthly. Senior staff members confirmed that they speak with service users about any change in needs. However service users were not fully aware that a review had taken place. One service user commented that he didn’t see any information “I don’t know what they think of me” whilst another service user said he hadn’t seen his care plan or been to a review. It is recommended that the service user sign the care plan review to confirm their involvement and their agreement to any decision made. The home maintains a daily record of visits from health care services, such as chiropody and optical care. Staff and services users said that the chiropodist Coote Lane Residential Home F57 F08 S49738 Coote Lane V238975 180805 Stage 4.doc Version 1.40 Page 10 and optician visited on a regular basis. A visiting district nurse said the care services are ”good, the best around here.” The approach of the home is to encourage independence of service users and policies of the home outline the rights of people to be treated with dignity and respect. Staff members were observed to speak politely to service users and respect their privacy during the inspection visit. Service users presented as relaxed and comfortable in the environment. Coote Lane Residential Home F57 F08 S49738 Coote Lane V238975 180805 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14 and 15 Dietary needs of service users are well catered for and service users exercise choice and control in deciding when and what to eat. The appropriateness of the social and therapeutic activities on offer will improve when led by an activities organiser. EVIDENCE: Staff members organise a range of entertainment and activities as noted from discussion and weekly management reports. Sometimes staff members find it is “not possible” to provide activities due to other demands on time. Service users spoken to said a singer comes in but one said he sings “the same old songs” whilst another service user said he “goes to his room” rather than listen. The registered manager explained that staff members encourage service users to play games and undertake therapeutic activities although these may not always be considered to be social events. The appointment of an activities organiser is recommended to ensure that social activities happen during busy times and that they are of a type that service users want thereby exercising greater choice and control. All service users having lunch were spoken to and everyone, apart from one person had enjoyed their lunch. The service user who hadn’t eaten was feeling unwell and had exercised her choice not to eat at lunchtime although alternatives were on offer. Special dietary needs are met. One service user who has diabetes said “sweets are made with special sugar and sweeteners”. Coote Lane Residential Home F57 F08 S49738 Coote Lane V238975 180805 Stage 4.doc Version 1.40 Page 12 Menus indicated that a balanced and nutritious menu including snacks and refreshments are available throughout the day that ensure service users have choice and a means of eating healthily. Coote Lane Residential Home F57 F08 S49738 Coote Lane V238975 180805 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The complaints process is clear to service users and staff. Adult protection procedures are comprehensive and meet professional guidelines. EVIDENCE: All service users spoken to are aware of the complaints procedure and know that a copy of the procedure is on the back of each bedroom door should they wish to make a complaint. One service user said if she had a problem “I would put a complaint in, or knock on somebody’s door.” Staff members are also aware of the procedure and are able to describe how they respond to any complaints raised, for example, one staff member said “complaints are dealt with as they occur.” A record of complaints, compliments and comments is maintained. The home has comprehensive adult protection procedures based on Department of Health guidance that meet requirements. Records show that appropriate training has been provided for staff. It is recommended that when a district nurse, is in attendance to a service user, they contribute to the formal risk assessment relating to bed rails to fully ensure the medical appropriateness of the restraint. Coote Lane Residential Home F57 F08 S49738 Coote Lane V238975 180805 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 25, 26 The premises are clean and hygienic and grounds are well maintained to the satisfaction of service users. The independence and safety of service users will be improved by the required installation of radiator guards that will enable service users to control the temperature in their own rooms without danger of scalding. EVIDENCE: The premises are in a good state of repair and have spacious well maintained grounds that were being enjoyed by several service users at the time of inspection. All areas within the home were seen to be clean and hygienically maintained. The domestic staff member spoken to was aware of her cleaning responsibilities and the safety aspects of her role. One service user said the premises “are beautiful” and “its lovely” here. A rolling programme of redecoration is in place as confirmed by staff members spoken to and by viewing the environment. Coote Lane Residential Home F57 F08 S49738 Coote Lane V238975 180805 Stage 4.doc Version 1.40 Page 15 The home was warm, safe and comfortable at the time of the inspection. Service users commented that they feel “safe and secure” living at Coote Lane. Radiators weren’t in use at the time of this visit but it was noted that the type installed are not low temperature surface radiators so must therefore be guarded to prevent scalding when on. Service users should have the facility to control the temperature in their own room that they feel comfortable with, unless a risk assessment determines otherwise. Coote Lane Residential Home F57 F08 S49738 Coote Lane V238975 180805 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 and 30 Recruitment, selection and training policies and procedures of the home are ensuring a competent and confident staff team who are delivering care services to a good standard. EVIDENCE: Recruitment and selection policies are thorough and the required checks to ensure suitability of appointees are undertaken. The system in use for recording interviews, and their outcome, is that of a sister home and was seen to be incomplete on two files. The registered manager agreed with the recommendation that the form should be adapted to Coote Lane’s use to ensure total relevance to the process. Training records indicate a high level of training provided and undertaken. Staff members spoke about induction workbooks and mandatory training, for example, fire safety and hygiene and infection control that they had undertaken. All senior staff and night staff have done handling of medicines training to the required standard. At the time of inspection two staff members were observed to be meeting with their NVQ assessor as a means of working towards achieving an NVQ qualification in care. Comments made by service users, in relation to questions about staff suitability and competence included “staff are very good” and “care is fine, no problem.” Coote Lane Residential Home F57 F08 S49738 Coote Lane V238975 180805 Stage 4.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 and 38 Service users are provided with facilities to look after their own money securely or have money held securely on their behalf if they so wish ensuring their autonomy and independence. Policies and procedures of the home, supported by staff training, enable staff members to provide effective care services within a healthy, hygienic and safe work and living environment. EVIDENCE: Secure facilities are provided for each service user in their own room so that personal money and valuables can be retained safely. The service users spoken to either retained their own money in the locked drawer in their room or a family member was looking after it. The money of nine service users, due to their personal incapacity and lack of personal representation, is kept in a locked safe in the manager’s office. Coote Lane Residential Home F57 F08 S49738 Coote Lane V238975 180805 Stage 4.doc Version 1.40 Page 18 Detailed and up to date records are available. Sampling of the savings for two residents showed the amount held and recorded to be accurate. Training records confirmed that staff members are undertaking training relating to safe working practices. Evidence was seen that hazardous substances were stored securely and staff discussion confirmed an understanding of safe practices in regard to use of cleaning materials and equipment. Water temperature control records are up to date and illustrated a temperature maintained around 43 degrees. It would be useful if the person completing the water temperature record, at present the registered manager signed and dated when completed, to improve accountability. Also it wasn’t clear that all staff had read and understood safe working practice policies, for example infection control, as a signature checklist in the file was incomplete. Coote Lane Residential Home F57 F08 S49738 Coote Lane V238975 180805 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x 2 3 STAFFING Standard No Score 27 x 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x x x 3 x x 3 Coote Lane Residential Home F57 F08 S49738 Coote Lane V238975 180805 Stage 4.doc Version 1.40 Page 20 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP25 Regulation 12(1) (a) 13 (4) (a) and (c) Timescale for action Radiators and pipeworks must be 01.10.06 guarded or have low temperature surfaces. A rolling programme of implementation must be produced that is prioritised according to identified level of risk. A copy of the planned implementation programme to be forwarded to the Commission for Social Care Inspection by the date indicated. Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard OP7 OP12 OP18 OP29 OP38 Good Practice Recommendations Care plan reviews should be signed by the service user or indicate the reason if the plan has not been signed by them. The appointment of an activities organiser is recommended. The visiting district nurse should be asked to contribute to the risk assessment relating to installation of bed rails. The interview assessment record should be adapted to relect the recruitment processes of Coote Lane. Policies and procedures should be signed and dated by F57 F08 S49738 Coote Lane V238975 180805 Stage 4.doc Version 1.40 Page 21 Coote Lane Residential Home 6. OP38 staff when read and understood. Water temperature records should be signed and dated by the person completing them. Coote Lane Residential Home F57 F08 S49738 Coote Lane V238975 180805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Levens House Ackhurst Business Park Foxhole Road, Chorley, Lancashire PR7 1NW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Coote Lane Residential Home F57 F08 S49738 Coote Lane V238975 180805 Stage 4.doc Version 1.40 Page 23 - 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!