Inspection on 18/10/07 for Coton House
Also see our care home review for Coton House for more information
This inspection was carried out on 18th October 2007.
CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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
What follows are excerpts from this inspection report. For more information read the full report on the next tab.
What the care home does well
Everybody the Inspector spoke with, the proprietors, manager and staff expressed the wish to provide a good service and to comply with any suggestions for improvement arising from the inspection. The Manager assesses residents before admission herself and also gathers assessment information from professionals involved. This helps her to determine whether the home can meet the potential residents needs before offering a place. Relatives are made welcome when they visit and two out of three relatives spoken to are very pleased with the overall service, regarding it as excellent. One visitor speaking about her Mom who is a resident said: `I`m not worried at all. I know she`s absolutely fine. I have a job to get her to come out. She says this is my home now. I have no worries about Mum at all. She is well looked after and absolutely fine. Nothing negative to say at all. I would rate the home as excellent.` Thirteen satisfaction surveys sent to residents by the home had been completed. These showed a high degree of satisfaction amongst residents and showed 100% satisfaction about activities provided. The range and quality of meals was also praised, although attention needs to be paid to meeting peoples assessed dietary requirements.
What has improved since the last inspection?
Exits have been alarmed to better protect residents with dementia who may wander from the home. Also the main handover period at 7.30am when the whole staff team changes has been staggered to ensure that staff are still available to supervise residents during this period. The manager feels that this is sufficient as there is not such a significant change in staff at other handover periods within the day. Since the last inspection the Fire Service has carried out a fire safety inspection and identified a number of contraventions. The proprietor and Manager assured the Inspector that all the identified areas for improvement have been met and they are awaiting an imminent re inspection.
What the care home could do better:
Several areas for improvement have been identified at this inspection. Care plans need to better reflect assessed need to ensure that sufficient care guidance is available to staff. This was identified particularly in relation to moving and handling residents, medication, pressure area management and special dietary requirements and preferences. Care plans are currently not person centred and at times this is reflected in practice, which is not always individualised and compromises the residents needs, choices and dignity. One resident who is not mobile and dependent on staff for all transfers for example told the Inspector that she is not informed of activities and often has to wait for staff to help her use the toilet. Managers challenged this view but staff meeting minutes confirmed that staff are not always working with all residents equally. The Inspector also observed one care staff member combing six peoples hair one after the other in the lounge using the same comb. This is outdated and institutional poor practice that fails to value people`s dignity, individuality and compromises infection control. Risk in relation to pressure sores and the use of bed rails must be better assessed. Safety systems in relation to the use of bedrails must also improve. Bed rails are currently in use to prevent one service user falling from bed. This had been discussed and agreed with a relative but planned risk assessments have not been carried out. Observation of the bed rails showed them to fit inadequately with the real risk of limb entrapment. A schedule of checks to ensure their safety is not in place and staff would benefit from training to ensure they know how to check bed rail safety during use. Changes in service users health are noticed and acted upon and routine health screening is also provided. Medication is generally well managed but stock control needs to be reviewed. This inspection found that very frequently used prescribed painkillers for one resident had run out. Although a delivery was due the following day, the outcome for the resident potentially is poor as there was no medication available to help her to manage pain should she have needed it. Recruitment is not adequately protecting service users. The files of two new staff were assessed. It was found that the very minimum pre employment checks are not being carried out in a timely way and this has the potential to put residents at risk. It is positive that the home is seeking service users views about the service they provide. This along with complaints and regulation 26 visits by the provider contributes to how the home is quality assuring its own performance. Currently however the home does not have a tool to help it to holistically review and act upon its own performance. Managers said following discussion that they are keen to instigate and develop such a tool.