Latest Inspection
This is the latest available inspection report for this service, carried out on 29th July 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 but made no statutory requirements on the home.
For extracts, read the latest CQC inspection for Coach House.
What the care home does well Daily audits of the quantity of medication are undertaken to identify problems promptly. What the care home could do better: Records made to indicate medicines are given to people must be signed at the appropriate time after they have taken their medication (or not), not before. The cupboard used to store controlled drugs must be fixed to the wall in a way which complies with the Misuse of Drugs (Safe Custody) Regulations. The temperature of the room used to store medicines must be monitored and recorded accurately. Random inspection report
Care homes for adults (18-65 years)
Name: Address: Coach House 10 Woodwards Heights Off Ward Avenue Grays Essex RM17 5RR one star adequate service 15/01/2010 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: Derek Brown Date: 2 9 0 7 2 0 1 0 Information about the care home
Name of care home: Address: Coach House 10 Woodwards Heights Off Ward Avenue Grays Essex RM17 5RR 01375396041 01375393197 Telephone number: Fax number: Email address: Provider web address: www.familymosaic.co.uk Name of registered provider(s): Name of registered manager (if applicable) Family Mosaic Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 13 Number of places (if applicable): Under 65 Over 65 0 physical disability Conditions of registration: 13 The maximum number of service users who can be accommodated is: 13 The registered person may provide the following category/ies of service only: Care home with Nursing Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Physical Disability Code PD Date of last inspection Brief description of the care home The Coach House is a registered home, providing nursing care for younger people with severe physical disabilities. The accommodation is a large, detached property of traditional construction on three floors. It is situated in a residential area of Grays
Care Homes for Adults (18-65 years) Page 2 of 10 0 3 0 6 2 0 1 0 Brief description of the care home and is fairly convenient for both rail and bus transport. The care provision is currently for thirteen service users requiring long-term care. The home employs trained nurses and carers to support personal and nursing care. Activities for service users in the community are encouraged and staff support service users in pursuing activities according to assessed needs. The Service User Guide and Statement of Purpose are available and the residents and their representatives are provided with this information. Care Homes for Adults (18-65 years) Page 3 of 10 What we found:
The reason for this inspection by a pharmacist inspector was to assess progress towards meeting the immediate requirement notice served at the random inspection on 3 June 2010 and the outstanding and additional requirements from that inspection. We wrote to you on 12 July 2010, with a warning letter, requesting an updated improvement plan to tell us what actions you were taking to improve outcomes for people using your service. This was received on 20 July 2010. During this inspection, we talked to staff about medication practices, observed medication being assembled for people to take, looked at medication storage, medication records for 8 people and associated care records where appropriate, and records of audits of medication. You were required by 4 June 2010 to ensure people are safeguarded by having their medication administered appropriately and that records were accurate. In looking at the records made when medicines are given to people, we found some minor deficiencies in the records where either there were unexplained gaps in the records giving no indication of whether medicines had been given or not, and in some cases records had been signed to indicate medicines had been given but the corresponding doses remained in the blister pack. We also saw that the daily audit record used to account for medication was incomplete for one person in that the record of any medication leaving the home, and being returned following social leave was inaccurate and we couldnt accurately account for the discrepancy in medication. However, there has been an improvement in the quality and accuracy of records and we consider this requirement has been met. You were also required, by 4 June 2010: 1. to ensure people received their medicines safely in accordance with the prescribers instructions, 2. to ensure that when medicines are not given to people, the reason why they are not must be recorded and any action taken, 3. to ensure that, where medication requires cold storage, it is stored within the recommended guidelines and the temperature is recorded each day. These were repeated requirements as the previous given timescales of 23 March 2009 and 15 January 2010 had not been met. During this inspection we found that the records indicate that medication is given in line with prescribers instructions, that any reasons for not giving medication had been recorded and, although there were no medicines requiring cold storage, the temperature of the fridge used to store medicines is recorded each day and was within acceptable limits. We consider these requirements have been met. However, we noted that the temperature of the medication storage room was being recorded inaccurately from the thermostat used to control the air conditioning unit, not the actual temperature of the room. The temperature was acceptable at the time of the
Care Homes for Adults (18-65 years) Page 4 of 10 inspection so we expect this to be managed by the home rather than make a further requirement on this occasion. Following the inspection on 3 June 2010, two further requirement were made. You were required by 4 June 2010 to: 1. ensure that where a variable dose of medication is prescribed, the specific dose administered is recorded, and 2. maintain an adequate supply of medication so that medication is available at all times and does not run out. We looked in detail at the records made when medicines are given to people and found that where variable doses are prescribed, the records showed the actual quantity given. We could find no record that medicines had been omitted as supplies had run out and this was confirmed by talking to staff. We consider these requirements have been met. In addition to the above we saw that for one person, the record made to indicate medicines were given to people were signed on assembly of the medication not after the person had taken the medication. This is unacceptable practice and we have made a requirement about this. We also saw that the cupboard used to store controlled drugs is not fixed to the wall in a way which would comply with the Misuse of Drugs (Safe Custody) Regulations and have made a requirement about this. 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 Adults (18-65 years) Page 5 of 10 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 2 14 Ensure there is evidence to 01/03/2010 demonstrate that the needs of the prospective person are assessed prior to admission. Not inspected on this occasion. So as to ensure the service can meet the needs of the individual person. 2 13 16 All people are given the opportunity to engage in appropriate in house and community based activities. Previous timescale of 31/3/09 not met. Not inspected on this occasion. So that people feel valued and do not become bored. 01/04/2010 3 34 18 All newly appointed staff (including agency staff) receive an induction. Not inspected on this occasion. So that newly appointed staff can effectively undertake their role. 01/03/2010 4 36 18 Ensure that staff, receive regular supervision. 01/03/2010 Care Homes for Adults (18-65 years) Page 6 of 10 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 Previous timescale of 23/3/09 not met. Not inspected on this occasion. This will ensure that staff, feel supported and able to carry out their role. Care Homes for Adults (18-65 years) Page 7 of 10 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 20 13 Records made to indicate 15/08/2010 medicines are given to people must be signed at the appropriate time after they have taken their medication (or not), not before. This will ensure records accurately reflect whether people have taken their medicines or not. 2 20 13 The cupboard used to store controlled drugs must be fixed to the wall in a way which complies with the Misuse of Drugs (Safe Custody) Regulations. This will prevent unauthorised access and meet legal requirements. 31/08/2010 Care Homes for Adults (18-65 years) Page 8 of 10 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 Adults (18-65 years) Page 9 of 10 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 10 of 10 - 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!
