Inspection on 23/02/06 for Coote Lane Residential Home

This inspection was carried out on 23rd February 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Coote Lane Residential Home 14/09/06

Coote Lane Residential Home 18/08/05

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 Inspection 23rd February 2006 09:00 X10015.doc Version 1.40 Page 1 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 Coote Lane Residential Home DS0000049738.V279691.R01.S.doc Version 5.1 Page 2 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 DS0000049738.V279691.R01.S.doc Version 5.1 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 Provider Web 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 Old age, not falling within any other category registration, with number (20) of places Coote Lane Residential Home DS0000049738.V279691.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should, at all times employ a suitably qualified and experienced manager who is registered with the National Care Standards Commission. Staffing must be provided to meet the dependency needs of the service users at all times and will comply guidelines which may be issued through the National Care Standards Commission regarding staffing levels in care homes. 18th August 2005 Date of last inspection 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 DS0000049738.V279691.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over a four- hour period. During the course of the inspection the Manager, a senior Carer, two care staff, a domestic assistant and eight residents were spoken to three of whom, were case tracked. This was the first inspection since the appointment of the new manager. 18 older people were resident at the home on the day of inspection. Procedures and documents were examined and relevant aspects of the premises viewed. Information included in pre inspection material and service user comment cards received by the Commission For Social Care Inspection (CSCI) helped to support the findings. Medication procedures and practices were also inspected at this time. A separate report of the findings of the Pharmacy Inspector will be produced. What the service does well: What has improved since the last inspection? What they could do better: A programme for installation of radiator covers is required to move the process forward now that risk assessments have indicated the priorities. Once installed the covers will enhance the safety of residents and minimise the possibility of scalding. Coote Lane Residential Home DS0000049738.V279691.R01.S.doc Version 5.1 Page 6 The Service User Guide must be reviewed and revised to provide current service information for residents. Water temperature records should be kept up to date to evidence the maintenance of safe temperatures. The views of residents, their family, friends and other stakeholders should be sought to evidence whether the home is continuing to meet its goals. A record of consultation with residents in regard to activities should be maintained to ensure activities are resident led. Training in moving and handling and the conditions of old age, for example dementia, should be provided, as proposed, to further develop staff skills and abilities. 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 DS0000049738.V279691.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Coote Lane Residential Home DS0000049738.V279691.R01.S.doc Version 5.1 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 the following standard(s): 1 The Service User Guide did not provide current details of the home’s services and facilities to enable an informed choice to be made about residency. EVIDENCE: The Statement of Purpose had been reviewed, met the requirements of the standard and was relevant to the current service provision. The Service User Guide had not been updated for some time and was therefore in urgent need of revision and reissue to residents. It was agreed that the review would be completed within a given timescale, a revised copy be issued to each resident and a copy forwarded to the Commission for Social Care Inspection (CSCI). Coote Lane Residential Home DS0000049738.V279691.R01.S.doc Version 5.1 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 the following standard(s): 7 Care plans were effectively developed and reviewed and used to guide daily practice. EVIDENCE: The files examined of the three residents case tracked indicated that information was reviewed regularly and that residents were invited to sign their agreement to the outcome of the review as previously recommended. Residents when spoken to said they had seen their care plans and were actively involved in the review process. When asked about the care provision one resident said, “Definitely looked after,” and “Staff good to me.” The information recorded in the care plans looked at, reflected the presenting needs of the residents spoken to. For example there were specific measure in place relating to one resident who displayed special needs. Coote Lane Residential Home DS0000049738.V279691.R01.S.doc Version 5.1 Page 10 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 the following standard(s): 12 and 13 The appointment of a designated activities organiser had ensured that all residents were involved in a range of individual and group activities that aided stimulation. Residents were enabled to see their chosen visitors in a safe and private environment. EVIDENCE: There was evidence from discussion with residents and sight of notice boards that a range of social activities took place. Residents said, for example, “Plenty of social activities if wanted.” Since the previous inspection a member of care staff had taken up extra hours on a Friday afternoon, as dedicated activities time. This was in addition to the general activity opportunities that were available each afternoon. Residents spoke about the Friday activities and referred to outings and support with shopping needs that had become available following the new arrangements. Although there was no written evidence available the manager had designed a suitable system for recording consultation, participation and satisfaction of residents that was to be shortly introduced. Coote Lane Residential Home DS0000049738.V279691.R01.S.doc Version 5.1 Page 11 Discussion with residents confirmed that their right to see visitors of their choosing at a mutually suitable time was supported. The visitors’ policy indicated that visiting times were flexible and that visitors were enabled to see their friends or relatives in private and partake of refreshments or arrange an overnight stay if appropriate. When asked if visitors were made welcome one resident replied, “Very much so.” Coote Lane Residential Home DS0000049738.V279691.R01.S.doc Version 5.1 Page 12 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 the following standard(s): 16 and 18 The procedure for dealing with complaints enabled residents and their relatives to feel confident that their concerns were listened to and acted upon. Adult protection guidelines. EVIDENCE: A copy of the complaints procedure was available in each bedroom for easy access of residents. This procedure was in keeping with the requirements of the standard and reflected the policy of the home. However, the complaints procedure, as outlined in the Service User Guide, was not adequate and is to be amended during the review of the Guide. The record of complaints was up to date and indicated that a recent complaint had been dealt with appropriately within the care home. All elements of the investigation and outcome were suitably recorded. Residents demonstrated an awareness of the process for making a complaint. Comments made by residents included, “Smashing here,” and “Nothing to grumble about.” As noted at the previous inspection robust adult protection procedures were in place. As recommended, at that time there are now procedures in place that ensure any installation of bed rails is effectively risk assessed and includes a district nursing assessment to ensure appropriate use of this equipment. Coote Lane Residential Home DS0000049738.V279691.R01.S.doc Version 5.1 Page 13 procedures were comprehensive and met professional 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 the following standard(s): 25 and 26 The independence and safety of residents will be improved by the required installation of radiator guards that will enable residents to control the temperature in their own rooms without danger of scalding. The premises were clean and hygienically maintained to the satisfaction of residents. EVIDENCE: Records and observation confirmed that the means of heating lighting and water storage were in keeping with good environmental standards. An assessment of risk in relation to radiator guards had been undertaken and priorities for installation identified. It was requested that a copy of the programme of installation be forwarded to the Commission For Social Care Inspection (CSCI) as soon as available to evidence intended commencement date and expected timescale for completion. The premises continue to be hygienically maintained and odour free. A domestic assistant spoken to confirmed her understanding of the safe use of Coote Lane Residential Home DS0000049738.V279691.R01.S.doc Version 5.1 Page 14 cleaning materials and equipment and her knowledge of systems for the control of substances that can be hazardous to health. A concern was raised about reduced domestic hours and the impact this could have on the in depth cleaning requirements within the care home. The manager confirmed that the current vacancy for domestic assistant is to be covered by additional hours undertaken by care staff to ensure standards of cleanliness are maintained. Comprehensive procedures for control of infection were in place. Coote Lane Residential Home DS0000049738.V279691.R01.S.doc Version 5.1 Page 15 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30 Staffing rotas, recruitment and selection procedures and training plans of the care home ensured the delivery of care services to a good standard. EVIDENCE: Staffing rotas were detailed, identifying the job role and hours of each staff member and off duty cover arrangements. There were adequate staff members on duty at the time of inspection. Current staff members were working additional hours to ensure full cover for three staff vacancies until new staff commenced. Records relating to newly recruited staff were examined and found to meet standard requirements. The interview assessment format that was to be adapted following a recommendation from the previous inspection was no longer in use. Records showed that systems were in place to assess individual training needs to plan for and provide suitable training. The newly appointed manager was aware that training for some staff members relating to moving and handling, was overdue and this matter was being addressed as a priority. Other training linked to conditions associated with old age, for example care of people with dementia was planned. To ensure that staff members have suitable skills and competence these training opportunities should be made available as agreed. Coote Lane Residential Home DS0000049738.V279691.R01.S.doc Version 5.1 Page 16 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 and 38 The culture of openness within the home and the use of formal quality assurance systems enable and encourage feedback as to how well the service is doing in meeting the needs of residents. Policies and procedures of the home, supported by staff training, enable staff members to provide effective care services within a healthy, hygienic and safe working and living environment. EVIDENCE: The home holds the Investors in People award and the ISO 9012000 both awarded by independent assessors of quality in services. Satisfaction surveys had been previously completed with residents, findings analysed and relevant action taken. These surveys were due to be undertaken once again and extended to other stakeholders. The manager confirmed that she had this matter in hand. Residents confirmed that they were consulted in regard to Coote Lane Residential Home DS0000049738.V279691.R01.S.doc Version 5.1 Page 17 their satisfaction with service provision through direct interaction and at residents meetings. Records confirmed that staff members were undertaking training relating to safe working practices. Moving and handling training is to be provided for new staff and to meet any outstanding staff training needs as a priority. 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, gas and electrical testing was up to date and certificated. Water temperature control records were not up to date. It was understood, as recommended following the previous inspection, that these records should be signed and dated by the person completing the form. Staff members had begun reading procedures and signing to confirm their understanding as previously recommended. Procedures should be reviewed regularly to ensure information remains current and relevant. Coote Lane Residential Home DS0000049738.V279691.R01.S.doc Version 5.1 Page 18 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 sCHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X 2 X STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X 2 Coote Lane Residential Home DS0000049738.V279691.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 OP1 Regulation 5 (6) (a) (b) Timescale for action The Service User Guide must be 01/05/06 reviewed and revised. A revised Guide to be issued to each resident and a copy to the CSCI by the date indicated as agreed. Radiators and pipe work must be 01/04/06 guarded or have low temperature surfaces. A rolling programme of installation to be produced and forwarded to CSCI by the date indicated. Requirement 2. OP25 12(1a) 13 (4a)(c) 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. Refer to Standard OP9 Good Practice Recommendations Medication policies and procedures should be reviewed to reflect current practice A second member of staff should witness all hand written annotations on Medication Administration Record charts. Medicines must be stored at the appropriate temperature. Coote Lane Residential Home DS0000049738.V279691.R01.S.doc Version 5.1 Page 20 2. 3. 4. 5. 6. 7. OP12 OP30 OP30 OP33 OP38 OP38 A record of temperature must be maintained for all areas where medicines are kept (fridge should be monitored daily). An activity log that records consultation and participation of residents should be introduced as agreed. Training in moving and handling should be provided as a priority. Training in conditions relating to old age, for example dementia should be sourced as planned. The views of residents, their family, friends and other stakeholders should be sought to evidence whether home is continuing to meet it’s objectives. Water temperature records should be kept up to date. Policies and procedures should be kept under review. Coote Lane Residential Home DS0000049738.V279691.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 DS0000049738.V279691.R01.S.doc Version 5.1 Page 22 - 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. 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