Care Home: Coote Lane Residential Home

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What the care home does well Before being admitted people had their needs assessed to establish if the service could provide the right care and support, before a placement in the home was offered. Records showed there was consultation with relevant people about the level and type of care required. Residents were given a contract outlining the terms and conditions of residence that protected their legal rights. Residents living in the home benefited from the support of a named worker referred to as a Key worker who took responsibility for their personal care. Resident`s also benefited from additional specialist support where needed, such as healthcare needs. Relatives were very satisfied with the standard of care and said `Always found the majority of staff to be very kind, caring and involved in mums care/well being`. Written comments from staff included `The home provides a good care for the service users needs`. And `the care home gives the support or care needed, above and beyond`.Good care planning meant residents were cared for as they wished and needed, and their needs regularly reviewed. Staff were instructed how to care for people safely and avoid unnecessary risks being taken. Observations and written evidence showed how residents living in the home were treated with respect, and their dignity maintained. Resident`s lifestyle was centred on them, and residents did not have to conform to any institutional practice such as set times for getting up or going to bed. Residents spoken to said they pleased themselves what they did and staff were always available to help them. Visiting arrangements were very good and the meals provided met with resident`s tastes and choice, and needs. Staff were observed as courteous and attentive when assisting those residents requiring support. The home recognises and accepts that from time to time complaints may arise. They informed us, `Complaints are seen in a positive light, any improvement on the quality of care is welcomed`. One relatives who provided written comments said `Any concerns I have had have been discussed and settled satisfactorily`. Records kept showed good procedures were followed. There was evidence to support the management respond quickly to vulnerable adult protection issues and follow correct safeguarding procedures when needed. They work well with other professionals to protect residents. Staff were trained in adult protection and knew their responsibility of care in this area. The home was well maintained, tidy, and provided a homely and pleasant environment for residents, visitors, and staff. The standard of cleanliness was very good. A relative commented ``the home is always spotlessly clean, and the residents always seems content`. Staff interviewed displayed a high degree of job satisfaction within a good team environment, and had good knowledge in understanding the needs of older people. Learning opportunities were very relevant to the homes purpose, and staff felt they were much appreciated for their work and were valued in the home. The home was very well managed and run in the best interests of the people living there. There is a commitment to meet with good practice standards and meet with regulatory requirements. They manage equality and diversity issues by, challenging discrimination, and providing responsive and accessible services to all residents and employees regardless of gender, race, age, disability, sexuality, or faith.Coote Lane Residential HomeDS0000049738.V370779.R01.S.docVersion 5.2Page 7Written comments from relatives showed the home was definitely run in the interests of the residents. Comments included, `I cannot find any fault, and I think for most families, care homes are not what we want for our relatives, but for most of us there is no alternative, but from my experience of Coote Lane I am very satisfied.` And, `They look after them well`. What has improved since the last inspection? Assessment and care planning included information about resident`s social, cultural, interests and hobbies backgrounds. Staff files showed recruitment checks to be complete and met with legislative requirements for Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) register check being applied for, prior to employment. All new staff are issued with a copy of the homes abuse policy and elder abuse guidelines so that there can be no confusion as to what constitutes abuse. Dementia Care training has been undertaken. The building is currently being re decorated through out, there is a running programme for all bedrooms to be re painted. New carpets have been put down through the main sitting area, dining room, hall stairs and landing and bedrooms are re carpeted as needed. An additional four bedrooms with en suite facilities is registered with the Commission and an extra communal area/conservatory for residents use. CARE HOMES FOR OLDER PEOPLE Coote Lane Residential Home Coote Lane Lostock Hall Nr Preston Lancashire PR5 5JE Lead Inspector Mrs Marie Dickinson Unannounced Inspection 14th & 19th August 2008 10:00a 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.V370779.R01.S.doc Version 5.2 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.V370779.R01.S.doc Version 5.2 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 cootelane@brookthorpeelaynehealthcare.co.uk 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 Mrs Eleanore Jay Hilton Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may only provide the following categories of service: Care home only - code PC, to people of either gender whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - code OP The maximum number of people who can be accommodated is 24 Date of last inspection 14th September 2006 Brief Description of the Service: Coote Lane provides residential care, for up to 24 people. Coote Lane is a purpose built home, situated in 5 acres of land within walking distance of the village of Lostock Hall. Accommodation offered is in single bedrooms. Some have en suite facilities provided. There are sufficient bathrooms and toilets, and various aids provided for residents to maintain independence throughout the home. Information about the service is available from the home for potential residents in a Statement of purpose and Service User Guide. Weekly charges for personal care and accommodation range between £400 and £435 per week. Residents are responsible for additional extras such as newspapers and toiletries. Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 Star. This means the people who use this service experience excellent quality outcomes. A key unannounced inspection was conducted in respect of Coote Lane on the 14th & 19th August 2008. The inspection involved getting information from an Annual Quality Assurance Assessment completed by the manager, staff records, care records, and policies and procedures. It also involved talking to residents, staff on duty, the deputy manager, manager from another service, and an inspection of the premises. Relatives and staff working in the home provided written comments, giving their opinion of the standard of service the home provided. Areas that needed to improve from the previous inspection were looked at for progress made. The home was assessed against the National Minimum Standards for Older People. An Annual Service Review was carried out on 14th February 2008, and the findings were, the home had continues to provide good outcomes for residents living in the home. What the service does well: Before being admitted people had their needs assessed to establish if the service could provide the right care and support, before a placement in the home was offered. Records showed there was consultation with relevant people about the level and type of care required. Residents were given a contract outlining the terms and conditions of residence that protected their legal rights. Residents living in the home benefited from the support of a named worker referred to as a Key worker who took responsibility for their personal care. Resident’s also benefited from additional specialist support where needed, such as healthcare needs. Relatives were very satisfied with the standard of care and said ‘Always found the majority of staff to be very kind, caring and involved in mums care/well being’. Written comments from staff included ‘The home provides a good care for the service users needs’. And ‘the care home gives the support or care needed, above and beyond’. Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 6 Good care planning meant residents were cared for as they wished and needed, and their needs regularly reviewed. Staff were instructed how to care for people safely and avoid unnecessary risks being taken. Observations and written evidence showed how residents living in the home were treated with respect, and their dignity maintained. Resident’s lifestyle was centred on them, and residents did not have to conform to any institutional practice such as set times for getting up or going to bed. Residents spoken to said they pleased themselves what they did and staff were always available to help them. Visiting arrangements were very good and the meals provided met with resident’s tastes and choice, and needs. Staff were observed as courteous and attentive when assisting those residents requiring support. The home recognises and accepts that from time to time complaints may arise. They informed us, ‘Complaints are seen in a positive light, any improvement on the quality of care is welcomed’. One relatives who provided written comments said ‘Any concerns I have had have been discussed and settled satisfactorily’. Records kept showed good procedures were followed. There was evidence to support the management respond quickly to vulnerable adult protection issues and follow correct safeguarding procedures when needed. They work well with other professionals to protect residents. Staff were trained in adult protection and knew their responsibility of care in this area. The home was well maintained, tidy, and provided a homely and pleasant environment for residents, visitors, and staff. The standard of cleanliness was very good. A relative commented ‘‘the home is always spotlessly clean, and the residents always seems content’. Staff interviewed displayed a high degree of job satisfaction within a good team environment, and had good knowledge in understanding the needs of older people. Learning opportunities were very relevant to the homes purpose, and staff felt they were much appreciated for their work and were valued in the home. The home was very well managed and run in the best interests of the people living there. There is a commitment to meet with good practice standards and meet with regulatory requirements. They manage equality and diversity issues by, challenging discrimination, and providing responsive and accessible services to all residents and employees regardless of gender, race, age, disability, sexuality, or faith. Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 7 Written comments from relatives showed the home was definitely run in the interests of the residents. Comments included, ‘I cannot find any fault, and I think for most families, care homes are not what we want for our relatives, but for most of us there is no alternative, but from my experience of Coote Lane I am very satisfied.’ And, ‘They look after them well’. What has improved since the last inspection? What they could do better: Medication given as when necessary requires more detail as to when this would be given, verbally tell someone if they were not well. To keep the home well maintained, the woodwork to the front of the home should be attended to. To make sure the right staff are employed to work in the home, it is recommended ‘to whom it may concern’ reference is not accepted. Induction training for staff must be documented and demonstrate a full induction is given to staff over a period of time, and in line with National Minimum Standards. All staff files should be up to date and complete. Meetings held for residents, relatives and staff, and staff supervision should increase in frequency. Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 8 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. The summary of this inspection report can be made available in other formats on request. Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 9 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.V370779.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People were consulted and had their needs assessed. This meant a decision could be made if the home was suitable to meet those needs. Contracts issued, informed people of the terms and conditions of living at the home, and protected their legal rights. EVIDENCE: Information received from the home informed the Commission they did well as, ‘‘At Coote Lane we understand that it is a very difficult decision to move into a care home and decide which one to move in to. To help with this we provide clear information about the services we provide and the level of care that we able cater to’. And, ‘Before admission all service users have an assessment to ensue that the home can meet the care needs of the service Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 11 user’. Written comments from residents and relatives showed most people considered they had enough information to help them make a choice. Several people had been admitted since the last inspection. Records seen showed they had a completed assessment of their needs that helped make a decision by considering if the home had the right facilities, and staff expertise to meet those needs. Social work assessments identified the need for residential care and the support people needed. The pre-admission assessment record identified personal care and physical well being, communication needs, medical history, food and meal times, diet and weight, medication information, dental and foot care, mobility and dexterity, mental health and cognition, personal safety and risk assessment, religious needs, daily living and social activities. Information recorded on the Annual Quality Assessment completed by the manager showed all residents had been issued with a contract. Copies of contracts were kept on resident files. Residents placed in the home by the local authority were given a contract for financial arrangements for payment. Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents had care plans, risk assessments, and a named key worker, which supported them to ensure their health and personal care needs being met in a consistent way. Medication was managed safely. EVIDENCE: Information received at the Commission indicated the home did well as, ‘At Coote Lane we assist in promoting high standards of health and personal care, and ensure that care needs are fully met by initial assessments, detailed care planning and regular reviews’. Three care plans were looked at in detail and one breifly. A short record was made of residents past history. Needs identified such as personal care, mobility, communication, personal safety, medication, medical, and social were listed. How identified needs are to be supported was generally clear. For Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 13 example, ‘offer assistance with washing and changing/dressing. One carer to bathe using bath hoist. Inform manager/senior if not managing. The objective recorded was to ‘promote high standards of hygiene. Maintain independence, and promote rights and choices’. Care plans were generally written with good attention to detail such as ‘ensure she wears her glasses’. And identified care needs in care plans instructed staff to maintain privacy, dignity, and independence. For example, ‘Respect wishes if declines’. This is clearly good practice, and was observed during inspection. Residents were allocated a named key worker to provide personalised care. This meant residents benefitted a continuation of their care support by people they knew and trusted. This is particularly beneficial for residents with dementia care needs. Written comments from relatives included, ‘Always found the majority of staff to be very kind, caring and involved in mums care/well being’. And, ‘Always felt that they ‘know’ mum-her likes and dislikes.’ Staff working at the home who provided written comments of their views, said the home did well because they ‘ensure all service users are given good care, and support.’ ‘The home provides a good care for the service users needs’. And the care home gives the support or care needed, ‘Above and beyond’. Residents had access to health care services both within the home and in the local community. All residents were registered with a GP and accessed local services either in the community, or were supported by visits to the home by health care professionals. This included visits from the district nursing team for nursing intervention as required such as applying dressings. All healthcares input were recorded and risk assessments completed such as, pressure care and diet and nutrition. Pressure care was promoted and pressure-relieving aids were used where need was identified. Risk assessments had been completed for moving and handling and were used as guidance for staff to help care for residents safely. Observations were made of wheelchairs and other aids being used correctly. The home operated a monitored dosage system for the administration of medication, which was dispensed into blister packs by the supplying pharmacist. An appropriate recording system was in place to record the receipt, administration and disposal of medication. Medication given as when necessary requires more detail as to when this would be given, particularly where it involves administering medication to residents unable to verbally tell someone if they were not well. A clear audit of medication received was kept. The record of medication adminstration was signed and storage of medication was secure. Staff responsible for administration had been trained. Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The homes routines are flexible and provide an environment where individual social, cultural, and recreational needs can be met. EVIDENCE: Residents’ care plans included details of their social and recreational needs and interests. For example ‘likes reading’, staff to ‘ensure she wears her glasses’. And, ‘staff to reassure when forgetful. Encourage to maintain interest in reading. Respect all choices decisions and wishes’. Recording residents’ choice for daily living and what they would like staff to consider could be expanded upon, such as preferred times for getting up and going to bed. Daily care notes however demonstrated residents did choose what they did, such as ‘lay in bed’, and ‘got up after lunch for tea’. Residents spoken to said they pleased themselves what they did and staff were always available to help them. Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 15 An activities programme was displayed in the home; and there was usually something residents could do in the afternoons. Routines in the home for staff had changed to allow for this time. Activities provided, included, dominoes, bingo, board games, entertainers, arts and crafts. Activity organisers are engaged for two hours each fortnight. Residents had the choice whether to join in or not. One relative wrote, ‘Mum is a very private person and this has always been respected’. Residents had recently enjoyed celebrating a 100th birthday. This had involved a private family party after dinner and later a party for all the residents to join in. There were two people who had reached this age. There was evidence residents had been encouraged to bring their own personal possessions and furniture with them. Comments from residents and relatives visiting showed visiting arrangements to be good. They could visit when they wanted and were offered refreshments. Privacy was respected during visits. Relatives said they were kept informed of important issues concerning their relation. Comments included, ‘All-important issues are discussed daily. I always know when the doctors or district nurse have visited and what mum has eaten that day. I have received phone calls even though they know I visit every day after work’. And, ‘The staff at Coote Lane are always very good at keeping in touch with relatives.’ Information received at the Commission told us some ways the home promoted equality and diversity. For example ‘Service users are encouraged to maintain hobbies and interest. Religious beliefs are respected and service users are assisted to practice if required’. All the residents spoken with said they were happy with the meals provided. If they didn’t like what was on the menu, the cook said an alternative would be provided. The cook also said she knew all the residents likes and dislikes, and took this into account when writing the menus. Menus seen were varied and the meal served during inspection was nutritionally balanced, and generous in portion. Meals can be taken in resident’s own rooms if they prefer to eat in private. Hot and cold drinks were provided throughout the day. The dining room provided a pleasant eating area for the residents. The meal times observed were unhurried and relaxed. Staff were seen to be courteous and attentive when serving meals and assisting residents where needed, with one to one support. Special diets were catered for. Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The complaints procedure was available and used properly, which helped residents/relatives have confidence to raise any concern they may have. There were policies and procedures, and appropriate training for staff in professional conduct and adult protection issues. This meant residents rights, safety, and welfare was promoted EVIDENCE: Residents spoken to said they had no complaints against the staff. Staff were described as being ‘very good’. One relative visiting said she would know who to speak to if unhappy about anything, but up to present never had any reason to make a complaint, as the management and staff were very good and available to speak to. Information received at the Commission for this inspection informed us, they recognise and accept that from time to time complaints may arise. They also said, ‘Any person that comes forward with a complaint will be protected and should not fear any retribution. The home has a complaints procedure in place, which is accessible for all service users, families.’ The home considers ‘Complaints are seen in a positive light, any improvement on the quality of Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 17 care is welcomed’. Relatives who provided written comments said they knew how to make a complaint and were satisfied any issue of concern was acted upon satisfactorily. ‘Any concerns I have had have been discussed and settled satisfactorily’. Records kept showed good procedures were followed. There were policies and procedures in place to ensure a proper response to any suspicion or allegation of abuse. Staff spoken to had a good understanding of the procedures to be followed and their responsibility to report any suspicion of abuse or neglect. They had received training in adult protection during induction training or on National Vocational Qualification (NVQ) in care. Staff sign a disclaimer for not accepting gifts, or being involved in residents financial affairs when they start work. Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,23,26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home was well maintained, clean, and tidy, and provided a homely and pleasant environment for residents, visitors, and staff. EVIDENCE: The process of refurbishing the home as identified in the last inspection had continued. Information for this inspection received at the Commission listed some improvements made. These included, four additional bedrooms with en suite facilities had been registered with the Commission and an extra communal area/conservatory for residents use. New carpets have been put down through the main sitting area, dining room, hall stairs and landing and bedrooms re carpeted as needed. Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 19 Residents said they liked their accommodation. It was a homely environment. Lounges were comfortable and visitors on the day said the home was always clean whenever they came. When people are admitted to the home, they can bring with them items of furniture and personal effects that can be reasonably accommodated in their bedroom. Bedrooms seen were personalised, clean, and comfortable, with aids provided where needed. The grounds were well maintained. The decorative woodwork on the property however was in need of attention as signs of decay were clearly visible. The home was exceptionally clean and furnished to a good standard. Laundry facilities were good and staff were provided with disposable gloves, aprons, and suitable handwash facilities. One written comment from a relative expressed an opinion ‘the home is always spotlessly clean, and the residents always seems content’. Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers of staff employed, training provided, and relatively safe recruitment practices, meant residents should be protected, and their needs effectively met. EVIDENCE: Relatives considered staff had the necessary skills to do their job. Comments included; ‘From what I have seen when I visit mum, they seem to do most things well’. And ‘They provide a friendly and caring environment, that meets the needs of all the residents.’ Rotas completed showed the compliment of staff was sufficient to cover all essential duties in providing care, and maintaining essential standards in the home such as hygiene and catering, and senior staff were on duty at all times. Staff files showed recruitment checks to be complete and met with legislative requirements for Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) register check being applied for, prior to employment. However more care is required with references. ‘To whom it may concern’, character reference is not suitable. All employees must have two references to support Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 21 their suitability for the position they have applied for. Most files showed interview notes had been taken. On appointment members of staff were issued with a contract of terms and conditions of employment. Employees were given a General Social Care Council (GSCC) code of conduct, and signed an agreement on the homes policies and procedures’ regarding confidentiality, gifts, wills, and bequests, whistle blowing, and quality policy, which were all covered in the staff handbook. Staff who provided written comments for the inspection said they had received induction training, and training relevant to their role as carer. Staff also considered their induction covered everything they needed to know, and they were given the right training to care for the residents. They said there was always enough staff on duty and they were supported to meet the different needs of residents. Records showed the induction-training programme carried out, covered their first day of employment. More evidence is required to show staff induction is a comprehensive basic training programme over a period of time that covers topics such as basic care, protection, and health and safety. Information received at the Commission informed us the home had improved by: ‘Dementia Care training has been undertaken. All new employees are issued with a copy of the homes Abuse Policy and Elder Abuse Guidelines’. They intend to: ‘Continue with mandatory training. Abuse Awareness training to be sourced for all staff’. Staff interviewed displayed a high degree of job satisfaction within a good team environment. Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is well managed and run in the best interests of the people living there. EVIDENCE: The manager is qualified and experienced in managing residential care homes. She has run the home since June 2006 and has over ten years experience in the care industry. Interim arrangements have been made for the deputy manager to act as manager on a daily basis, until the registered manager has returned from special leave. Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 23 The roles of the management team includes seniors, to support the management team and take responsibility for a number of residents and staff employed. There are clear lines of accountability, and management skills combined support an effective quality service delivery for residents in the home. Information received at the Commission informed us the manager had gained a lot of experience over the last 12 months that improved her competence in management. Insurance cover is sufficient in ensuring against any loss or legal liabilities. There is a commitment to meet with good practice standards and meet with regulatory requirements. Minutes of the different meetings for all parties showed for example, resident’s meetings, relatives meetings, and staff meetings. Topics discussed at meetings included issues such as care plans and reviews, activity logs, resident care, medication records and issues around the home, such as kitchen and laundry, health and safety. The frequency of meetings could improve. Staff who provided written comments and those spoken to during inspection said they were supported in their work and management were approachable. Coote Lane was a ‘Good place to work’. ‘Plenty of training provided’. And ‘Staff pride themselves in their work’. Records of individual supervision for staff should be made and kept on staff file for reference. Written comments from relatives showed the home was definitely run in the interests of the residents. Comments included, ‘I cannot find any fault, and I think for most families, care homes are not what we want for our relatives, but for most of us there is no alternative, but from my experience of Coote Lane I am very satisfied.’ And, ‘They look after them well’. The home sent us their annual quality assurance assessment (AQAA), that gave us information we asked for. For example, how equality and diversity issues were managed. We were informed, ‘We will promote equality and diversity by challenging discrimination, providing responsive and accessible services to all our service users and employees regardless of gender, race, age, disability, sexuality or faith, and ensuring that our workforce is reflective of the wider population’. The home does not handle residents money or valuables however small amounts of individuals money can be held at the home for safekeeping, with regular auditing in place to protect people requiring this service. Policies and procedures in the home were being reviewed and made available for staff. Confidential records were locked away. Record keeping and filing systems could improve. This will help to ensure records required by the Care Homes Regulations 2001 are complete and up to date. These include the records referred to in schedule 2 in relation to staff. Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 24 Information received at the Commission showed regular maintenance of services such as heating and electrical equipment had been carried out. Training in health and safety was also provided for staff. Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 25 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 3 3 X X 3 X X 4 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 To support residents with communication difficulties, medication to be administered ‘when required’, should have more detail of the circumstances or symptoms that staff must know about. It is recommended the woodwork to the front of the home be attended to. It is recommended ‘to whom it may concern’ reference is not accepted, for deciding on the suitability of a person to work in the home. Induction training for staff must be documented and demonstrate a full induction is given to staff over a period of time, and in line with National Minimum Standards. Meetings held for all parties should increase in frequency. DS0000049738.V370779.R01.S.doc Version 5.2 Page 27 2 OP19 3 OP29 5 OP30 6 OP33 Coote Lane Residential Home 7 8 OP36 OP37 Supervision given to staff must be at least six times a year and a record of this kept on staff files. All staff files should be up to date and complete. Coote Lane Residential Home DS0000049738.V370779.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North West Region 3rd Floor Unit 1 Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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