Care Home: Coalway Lane Nursing Home

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What the care home does well The home collects detailed information about the person before anyone moves into the home to make sure they can meet their needs. Staff support individuals to make decisions and choices about their lifestyles so that they can take risks in their everyday activities. The care plans are extremely detailed and are completed with the person and a named member of staff.The plans show how individuals are supported to improve their skills and meet their expectations. People are supported to access all health care agencies,including specialist services. Staff support everyone to develop and maintain community links,leisure activities and make sure everyone`s rights are respected. People are supported to regain independent living skills and are given support to achieve this. Staffing levels are excellent and their experience and ongoing training makes sure they have a good understanding of individual needs.This in turn promotes people`s well being. All checks and clearances are received before anyone starts to work at the home. The views of people using the service are always taken seriously and they are involved in the daily routines of the home. Clear information is available should anyone have a complaint or concern about the care or service they are receiving. There are good checks in place to make sure the home remains safe and maintained. The manager leads a good team of staff who show an openness and respect for the people they are caring for and continually develop the service. Surveys were returned to the Commission from people using the service and comments included: "Always make decisions and staff treat me well." "I was told it was alright and found it alright when I moved in." "There are meetings every four weeks and can see the staff anytime." "The staff always listen." "I love living here." What has improved since the last inspection? The staff have had training in working with people with Learning Difficulties. Staff have continued to have training so that they can support the people living in the home and develop the service. What the care home could do better: There should be a planned redecoration and refurbishment plan so that the houses remain pleasing places to live. All bathing and toilet flooring need to upgraded,light cords renewed and a washing machine with specific programmes provided. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Coalway Lane Nursing Home 4 Coalway Lane Swalwell Gateshead Tyne & Wear NE16 3EY     The quality rating for this care home is:   three star excellent service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Irene Bowater     Date: 0 5 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Coalway Lane Nursing Home 4 Coalway Lane Swalwell Gateshead Tyne & Wear NE16 3EY 01914886877 01914961926 coalway@mentalhealthconcern.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Jason Desmond Reeve Type of registration: Number of places registered: Mental Health Concern care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: The LD service user category relates to one current service user only. Date of last inspection Brief description of the care home Coalway Lane is a group of three four bedroomed houses that have been purposely built to provide nursing care for twelve adults with mental health needs. The houses blend into the community well and comprise of three domestic style houses. The houses are detached but share a garden at the rear of the building. Each house contains four bedrooms, 2 lounges, dining room, kitchen, laundry, toilets and bathrooms. There is a converted building attached to one house, which contains staff facilities and two offices. Most back doors have steps leading to them but all of the front doors have level access. Coalway lane forms part of a housing estate in Swalwell. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 5 1 12 Brief description of the care home The home is near to the Metrocentre and local shops. A bus service runs locally to the town centre, Gateshead and Newcastle. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Before the visit we looked at,information we received since the last visit on the 1 March 2007.We looked at how the service has dealt with any complaints and concerns since the last visit.We looked to see if there had been any changes to how the home is run and gain the providers view of how well they care for people.We also sought the views of people using the service,staff and other professionals. We have reviewed our practice when making requirements,to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations,but only when it is considered that people Care Homes for Adults (18-65 years) Page 6 of 28 who use services are not being put at significant risk of harm. In future,if a requirement is repeated,it is likely that enforcement action will be taken. Mental Heaths Concerns Nursing Services are commissioned by service level agreement by NHS Statutory Agencies(PCTS) and form an integral part of the localities health services. Therefore no charge is made to any person who is referred to any of the Nursing Homes. An unannounced visit was made on the 5 January 2009.The visit was carried out by one inspector and took six hours to complete. During the visit we talked with people who use the service,staff and the manager.We looked at information about the people who use the service and how well their needs are being met.We looked at other records which must be kept and checked that the staff had the knowledge,skills and training to met the needs of the people they care for. During the visit we looked around the building to make sure it was clean,safe and comfortable. We told the manager what we found. What the care home does well: What has improved since the last inspection? The staff have had training in working with people with Learning Difficulties. Staff have continued to have training so that they can support the people living in the home and develop the service. Care Homes for Adults (18-65 years) Page 8 of 28 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Excellent assessments of individual needs are carried out and people can be sure that the home they choose will meet their needs. Evidence: Each person living in the home has a very detailed assessment before moving into the houses.The assessments cover previous life experiences,general and mental health, social,spiritual and culteral needs. Information is available from various sources including care managers,hospitals and community services. The individual is central to this assessment and the staff make sure that they fully involve the person and their representatives from the begining in the care planning process.After the initial assessment there are ongoing reveiws to make sure that the persons needs are being met. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: Each person has a contract which gives clear information about the charges and what extras have to be paid for.Should there be any change in peoples circumstances the contract would be reveiwed. Care Homes for Adults (18-65 years) Page 12 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Opportunities to take part in life risks and choose how to make major decisions are extremely well managed.This means people can be actively involved in their chosen lifestyle Evidence: The care plans showed that the staff support people to live an independent lifestyle and are able to make their own decisions are have the same rights as everyone else to take risks in their lives.Should there be any limitations this is fully discussed,agreed and recorded with person. Care plans are person centred and focus on peoples strengths and show how staff work with the person to maintain and try to continually improve peoples lifestyle. There is a named nurse and co worker system in place which lets staff work on a one to one basis and build up trust and respect with the people living in the home. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: The plans were detailed, written and agreed with the person, up to date, and easy to follow, particularly in relation to their complex mental health needs. Risk assessments are in place and include triggers and how staff are to interact to manage any difficult behaviours. Any limitations have been identified through the assessment process. For example one person agrees to one bath a week and needs prompts to manage personal care and housekeeping tasks.Another plan shows how someone is to be supported to travel unaccompanied and another shows how staff try to make sure that a healthy diet is taken. People are supported to access NHS services and facilities as and when they need to. The care plans showed that the specialist advisors are used for individual people living in the home. Care Homes for Adults (18-65 years) Page 14 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Opportunities to take part in meaningful activities and keep control of everyday decisions are good.This means people can live full and active lives. Evidence: All the people living in the home are encouraged and supported to live an independent lifestyle according to their degree of ability and choices. Some,due th their metal health history do not choose to be completely independent and need staff support to achieve daily living tasks such as cooking,shopping and personal care. Some find choices difficult to manage and staff and the individual have completed care plans and risk assessment to show improvements can slowly happen. Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: People are encouraged to have own leisure activities and maintain family links. One person spent Christmas with family and another is going unaccompanied to London.There are flexible routines but some need the structure and support of staff to achieve this. The staff promote independence and individuals are supported to shop and cook meals. Staff are there to advise and make sure as far as possible healthy eating. Care Homes for Adults (18-65 years) Page 16 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Access to health care is excellent.Comprehensive care planning and support demonstrates that peoples needs are being fully met. Evidence: The aim of the service is to support people maintain and develop self care abilities.This includes personal hygiene,medication,finance,nutrition and daily living skills. Everyone living in the home has excellent access to a wide range of heath care professionals.This includes continued support of the hospital team including regular consultancy visits.And staff are able to demonstrate a good understanding of individuals physical and mental health care needs. The care plans show comprehensive clinical details and risk assessments show how the staff support people to manage their care needs.The staff spoken to have an excellent insight into each persons problems and work hard to maintain and improve peoples health care. Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: Most of the staff have worked with the people for a number of years and there has been a development of mutual respect and trust that has buldt up over this time. There are policies and procedures in place to make sure people receive their medication safely.Where possible staff encourage people to self medicate. Should someone be unable to do this staff dispense and record when medicines are administered. And each person has a lockable facility in which to store medicines safely. Regular,sometimes daily checks are completed to make sure medication is taken as prescribed. Care Homes for Adults (18-65 years) Page 18 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good complaints and safegaurding procedures are in place which protect people from harm. Evidence: The complaints policy and procedure is available in the home and given to people in the Service User Guide. People felt that the staff are approachable and listen to what they say. It was evident throughout the visits that everyones opinion is valued,all issues are discussed and negotiated to a positive outcome. Staff are receiving Safeguarding training which follows Gateshead Local Authority Guidance.This means that they would know what to do should there ever be any allegation of abuse. There have been no complaints or safeguarding referrals made to the Commission or Local Authority. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provides three good sized domestic homes which are clean,comfortable and pleasant places for people to live. Evidence: There are three detached four bedroomed houses each with all of their own facilities.One house has a downstairs bedroom which would be suitable for someone with mobility needs.Others need to be able to manage the stairs. One house has a conservatory which is used as a designated smoking area and all houses have gardens and level access.The other houses also have a designated smoking area only for use of those living in the home. Each house is nicely decorated and furnished although there is starting to be some wear and tear to furniture and the decoration. The flooring in all of the bathrooms,toilets and showers is looking grimy and is difficult to keep clean.And all of the light cords are really dirty from constant use and cannot be cleaned. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: All of the bedrooms are single and people have brought items with them that reflects their lifestyles and personal preferences. In house 4 the laminate on the front of the kitchen unit is peeling off due to the heat being generated by the dishwasher and the whole unit is ill fitting. The people living in the home are responsible for completing all household tasks.The staff support them to make sure the houses are kept clean and tidy. They are also responsible for their washing.All of the machines are domestic and none have a specified programme to meet disinfection standards should there be any infection outbreak. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems around recruitment,selection and training are excellent which means people can be sure that all of their needs are met and they are protected. Evidence: The service has a registered manager and a deputy manager.The manger is supernumerary.Including the manager and deputy there are nine Registered Mental Health Nurses and five support workers.Four support workers have National Vocational Qualification Level (NVQ) 2 and one has completed NVQ level 3 in Health and Social Care. During the day there are three staff on duty,sometimes there are two qualified nurses and support staff.Overnight there is always a qualified nurse who sleeps in and one waking support staff. The organisation has a dedicated training department and staff are supported and encouraged to go on a wide range of training.All staff have completed statutory training and other training includes working with people with a learning disability,equality and diversity and the Mental Capacity Act. The service is also an apporoved centre with the University and offers clinical training placements to student nurses. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: The recruitment files are held centrally but can be accessed when required.Staff confirmed that references are obtained and Criminal Record Bureau checks are available. Staff have a very clear understanding of their roles and responsibilities. There is a very low turnover of staff and they have built up excellent relationships with each other and the people living in the home. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run by a competent manager who makes sure good quality assurance and safety systems are in place.This makes sure that the people living in the home receive a good quality of care. Evidence: The manager is registered with the Commission and is a first level nurse with a wealth of experience.He leads a strong staff team who have worked with each other for some time. Regular meetings take place including staff training needs through Clinical Governance,Health and Safety and development of the service. Staff continue to work hard to continually improve the quality of lives of the people living in the home. There are regular meetings and those living in the home have a forum where they can express their views and be involved in the running of the home as they wish. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: Quality assurance systems are in place.These include medication and care plan audits.The senior managers also visits on a regular basis and also complete audits of all aspects of the service. Accident and incident forms are completed and sent to head office.They then track any trends and inform the Commission of any events that affect anyone living in the home. All contracts are in place and regular maintenance records for fire,water temperatures,fridges and freezers are available. Regular fire drills take place and the Fire Officer visited on the 18 November 2008. The requirement from that visit is being completed.Individual fire risk assessments and plans are available. Health and safety and individual risk assessments are up to date and regularly reviewed Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R 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, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 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, Care Homes 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 27 23 The registered persons must 07/09/2009 ensure that the flooring in all bathing and toilet areas are replaced. This will make sure that the areas are pleasant to use and easy to be cleaned 2 30 13 The registered persons must 30/03/2009 ensure that all of the light cords are replaced. This will make sure that they are easy to be cleaned and prevent cross infection 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 30 It is highly recommended that a washing machine with a disinfection programme be provided. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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