You are here

Archived: BLHC Coote Lane Limited Good

The provider of this service changed - see new profile

Reports


Inspection carried out on 25 September 2018

During a routine inspection

We carried out an unannounced inspection at BHLC Coote Lane Limited (referred to throughout the report as Coote Lane) on 25 September 2018.

Coot Lane is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Coote Lane is registered to provide personal care for up to 24 people. There were 21 people living in home at the time of this inspection, some of whom were living with dementia. Accommodation is provided in single bedrooms, some with en-suite facilities, over two floors. A passenger lift is available to assist people to move freely around the home.

At our last comprehensive inspection in May 2017 we found improvements had been made. However, there were continuing shortfalls in relation to the way medicines were handled in the service and the lack of robust procedures to protect the rights of people who could not consent to their care in Coote Lane.

Following the inspection, the provider sent us an action plan which set out the action they were taking to meet the regulations. On this inspection of 25 September 2018, we found good progress had been made and the provider had met the action plan and was no longer in breach of the regulations. Medicines were judged to be well managed. The home was now complying with the requirements of the Mental Capacity Act 2005 to ensure that people’s rights were being upheld in line with the Act.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The registered manager had been in post for just over 12 months and was solely responsible for this home. People living in the home, their relatives and staff all spoke very highly of the new manager and the improvements made since her arrival and the change in management structure.

People felt safe living in Coote Lane and with the staff who supported them. Staff in the home were aware of their responsibilities in relation to protecting people from harm or abuse. Staff had received training and there was suitable guidance in place about making safeguarding referrals.

People were supported by staff who knew them well and were focussed on promoting their independence and well-being. The home assessed people prior to coming into them coming into the home to ensure that their needs could be met. This was followed by on-going assessments and care plans that were developed with the individual to set out how their needs were to be met.

Staffing levels were suitable for people’s needs. Staff recruitment was done correctly so that only suitable staff cared for vulnerable people.

There was a stable staff team who had the skills and knowledge to meet people's needs. The home had a programme of training and on-going staff supervision which ensured staff had up to date guidance and information for their roles.

People received the support they required to maintain good health. Medicines records were accurate and supported the safe administration of medicines. The home worked in partnership with external healthcare professionals. Healthcare professionals gave positive feedback on the care and of the monitoring of peoples changing health needs.

People were supported to have maximum choice and control of their lives; the policies and systems in the service supported this practice. The staff understood their responsibilities under the Mental Capacity Act 2005 and people’s rights were upheld.

People were involved in planning their own support and the activities they wanted to take part in. There was a programme of activities for people to take

Inspection carried out on 15 May 2017

During a routine inspection

We carried out an inspection at BHLC Coote Lane Limited (referred to throughout the report as Coote Lane) on 15 and 16 May 2017. The first day of the inspection was unannounced.

Coote Lane is registered to provide personal care for up to 24 people. There were 23 people using the service at the time of this inspection. Accommodation is provided in single bedrooms, some with en-suite facilities, over two floors. A passenger lift is available to assist people to move freely around the home.

At our last comprehensive inspection on 19 October 2016 we found the provider was not meeting a number of regulations. We therefore asked the provider to take action in relation to person centred care, the need for consent, good governance and staff supervision. In addition, we issued a warning notice to help ensure people always received safe care and treatment.

Following the inspection, the provider sent us an action plan which set out the action they were taking to meet the regulations. This inspection in May 2017 was undertaken to check whether the required improvements had been made.

There was a registered manager in place. They were also registered manager at another home owned by the provider in a different area of Lancashire. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

During this inspection we found some improvements had been made. However there were continuing shortfalls in relation to the way medicines were handled in the service and the lack of robust procedures to protect the rights of people who could not consent to their care in Coote Lane. You can see what action we told the provider to take at the back of the full version of the report.

We identified shortfalls in the management of medicines. This was because administration records did not provide evidence that people had always been given their medicines as prescribed. In addition, the use of prescribed creams was poorly documented, although there were no concerns regarding the skin integrity of anyone living in the home.

Although the registered manager had submitted DoLS applications for three people who used the service, they had failed to ensure that the necessary application was submitted for a person who was in receipt of one to one care and was unable to consent to these arrangements.

Risk assessments were in place in relation to the care people required. These had been regularly reviewed and updated to ensure they accurately reflected people’s needs. We have recommended the provider ensure risk assessments are put in place in relation to the security of the building and the smoking area used by people who used the service. We have also referred the matter regarding unsafe smoking practices to the fire authority.

People were cared for in a safe and clean environment. Procedures were in place to prevent and control the spread of infection. Regular checks were made to help ensure the safety of the equipment used. Systems were in place to deal with any emergency that could affect the provision of care.

People told us they felt safe in Coote Lane and that staff were kind and caring. People who used the service told us staff always respected their dignity and privacy. Staff were aware of the action to take should they witness or suspect abuse and were confident they would be listened to if they raised any concerns with the registered manager.

We found people were cared for by sufficient numbers of suitably skilled and experienced staff who had been safely recruited. Staff had received the essential training to enable them to deliver effective care, although the system to record when refresher training was due needed to be improved. We have recommended that the provider ensur

Inspection carried out on 19 October 2016

During a routine inspection

This inspection took place on 19 October 2016 and was unannounced. BLHC Coote Lane Limited provides accommodation and personal care for up to 24 older people. There were 23 people at the service at the time of our inspection. People were living with a range of care and health needs, including those associated with medical conditions and people living with dementia. Many people needed support with all of their personal care, and some with eating, drinking and mobility needs. Other people were more physically independent and needed less support from staff.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

BLHC Coote Lane Limited was last inspected in January 2014 and was found to be compliant in the outcomes inspected.

Risks to people's safety and welfare had not been appropriately assessed and actions to reduce those risks were not always documented. The service had not always taken steps to manage risks to people's health and well-being. Risk assessments were not always evident in people's care plans.

Care was not always person-centred. Care plans were in place however they were not always reflective of people's current needs and wishes. They were not always reviewed on a regular basis however; changes were not made to them to ensure they were updated as people's needs changed. Staffing levels were sufficient to meet people's care needs, but not to ensure that they had the opportunity to engage in activities or to spend time talking and relaxing with members of staff.

Some quality assurance processes were carried out however; they were not frequent or effective in monitoring the service and identifying areas where improvements were required. The registered manager informed us that care plans were being redesigned with an emphasis on person centred choices. Not all had been done at the time of our inspection. We found instances where risk assessments in people's care lacked key information which staff members required to effectively manage risks. We also found that not all care plans provided sufficient detail to give staff the information they needed to provide personalised care and support that was consistent and responsive to their individual needs.

Staff members felt supported, however did not always receive formal support from the service. They did not receive regular supervision sessions but did feel they were able to raise issues as they needed to.

People told us they enjoyed the food and were offered a choice of where they would like to sit and that they could request alternatives if they did not like what was on the menu. However there was no information displayed or in the kitchen regarding allergens contained in the food produced.

People were supported to make and attend appointments with their GP and other healthcare professionals, both within the service and the local community.

Inspection carried out on 9 January 2014

During a routine inspection

We spoke with six people and asked them if the care and support they received was to their satisfaction. People told us, �It�s very good...If I need any help I get it. Last week I enjoyed armchair exercises. A young man came in and showed us to keep moving even when we are sat down. It was good.� �Everything is O.K�I like living here. You get everything you need. They (staff) do their best and are good to me.� �I would never want to leave here. I like to look out of my window and watch the world go by. I�m sometimes bad with my chest. They send for the doctor straight away and look after me properly. The place is spotless and the food is very good.� �I tend to forget things easily but they (staff) will remind me. I like chatting with them and if I need any help, of course they help me no questions asked.�

People�s care and treatment was planned and delivered in a way that helped to ensure their safety and welfare. Staff were trained to support people at risk of falling, developing pressure ulcers or who may not eat enough. Professional help was sought when needed.

People were happy with the quality and choice of food provided. We were told, �The foods nice, you will never go hungry.� We found the meal served was wholesome and nutritious and portions were generous. People needing support to eat was given this with dignity.

People were cared for by staff that were supervised and trained and people had opportunities to give their views about their care and treatment.

Inspection carried out on 10 January 2013

During a routine inspection

People had a good assessment of their needs and they had consented to their care and support. People told us they were treated with kindness and respect. We observed staff spoke to people respectfully and attended to personal care needs as required. People had very good care plans written that placed them at the centre of their care.

People told us �They always ask me if I need help. They are very good�. And �They do chat about your care and what is wanted. I�m quite contented. I have everything I need�. People told us they could choose the gender of their carer. One person said ��is absolutely lovely. He has a lovely personality and I have no problems letting him help me with my personal care�. We were also told �When they come to my room they always knock on the door, even if they are just bringing me a hot drink. We get well looked after�. �They (the staff) are pleasant and very helpful. When I�m having a bath I am given the privacy I need. Just knowing they are in the background makes me feel safe and confident�.

People thought activities could be improved.

We found people had their medication administered correctly and when they needed them. People were cared for by staff of good character and who were trained. People told us there was always enough staff and described staff as being �very well qualified�, �Very helpful�, and �Good at their job�. One person told us �One good thing here is they (the staff) never try to make you rush.

Inspection carried out on 19 July 2011

During a routine inspection

Not all people living in the home could give their view of their life experience. Relatives visiting told us they were involved in the admission process. One relative commented, �We looked around other homes before deciding on this one. It had a homely atmosphere that would suit mum. Absolutely no complaints, first class service all round�.

People had their needs assessed. This gave them and their representatives an opportunity to discuss how they would like their care to be provided. We spoke to relatives who told us they considered in general their relatives had the all the support they needed. This included their health, personal and social care needs. They told us, "It is very good here. The staff are friendly.� �It is open visiting and they always make you feel welcome. They will ring up if there is any concern. Mum had not been well a few months ago and they rang straight away. The cleaning in the home is excellent and mum always looks really nice.�

People told us staff were attentive to their needs and always responded to their call for assistance. They did not feel hurried and staff helped them as they wanted. One person told us, �When I ring for assistance, they always knock before they come in my room�.

Visitors considered staff were respectful to people in the course of their duties and were friendly and accommodating when they visited. They were made welcome at any time.

There were good arrangements in place for safeguarding people to make sure people were protected from abuse and their human rights upheld. There were no institutional practices and people reported there no expectations they had to conform to set routines.

People living in the home said staff cared for them as they wished. Comments were made such as, �Most of the staff are very nice, they will do anything for you, just ask and it�s done�. �The staff are friendly and always ask if I�m all right�. Relatives visiting commented on the dedication of staff in making sure peoples� needs were attended to. They had no concerns as all the staff were very good.

Relatives we spoke to said they were confident the manager and staff would deal with any query or issue of concern they may have.