We carried out a review of the data available to us about Coote Lane Residential Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Coote Lane Residential Home, you can give feedback on this service.
Coote Lane Residential Home is a residential care home providing personal care to 22 people aged 65 and over at the time of the inspection. The service can support up to 24 people. There is a large dining room, communal areas, and a conservatory area.
People’s experience of using this service and what we found
Medicines were stored and administered safely. People were supported safely, and the provider had plans in case of emergencies. The home was clean and hygienic, and staff were seen to wear appropriate personal protective equipment (PPE). Staff were employed following a safe and robust recruitment process. Safeguarding training was mandatory, and staff were aware of the processes to follow to enable people to keep safe.
Staff felt supported by the management team and the induction and ongoing training they received. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. A person told us, “We’ve done surveys, and [the manager] talks to us regularly and asks us what we think about different things." Mealtimes were relaxed and organised around people's individual daily routines. A relative said, “The chef is amazing.” People were supported to have access to healthcare professionals and their healthcare needs had been met. The service worked in partnership with other organisations to ensure they followed good practice and people in their care were safe.
The provider had various methods to assess, monitor and improve the quality of the service. People and staff told us there was a very positive culture at Coote Lane Residential Home. A person explained, “If I wanted something doing, they would do it, like a shelf moved etc, or a bigger TV. They said to me when I came ‘This is your home’.” A relative told us, “We’ve been very pleased. You can go to [registered manager] with any issues, and she’s open to ideas”. The management team positively engaged in the inspection process and the registered manager clearly understood their regulatory responsibilities. The provider and management team had been responsive in implementing positive change and working with health and social care professionals to improve people’s quality of life.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 04 June 2021).
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
At our last inspection we recommended the provider considered best practice guidance on infection prevention. At this inspection we found improvements had been made.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance the service can respond to COVID-19 and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Coote Lane Residential Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Coote Lane Residential Home is a residential care home providing personal and nursing care to 17 people aged 65 and over at the time of the inspection. The service can support up to 24 people.
People’s experience of using this service and what we found
Some care plans lacked some information related to people’s individual needs and behaviours. The auditing processes in place did not identify the concerns we found. A new management team had recently been employed to lead the staff and manage the home. Staff told us positive changes had taken place and they were updated on planned future improvements. The management team worked in partnership with a variety of agencies to ensure people's health and social needs were met. Onsite face to face visits by families had commenced to promote people’s wellbeing.
Not all staff followed good practice guidance and company policy. They travelled to and from work in their uniforms, rather than getting changed when at the care home. We have made a recommendation about infection prevention. Medicines were managed safely by trained staff and people received their medicines as prescribed. The home was very clean and used infection control measures to reduce the risk of COVID-19. Staff were aware of individual risks to people and were knowledgeable about how to safeguard people from abuse. Staff had safe recruitment checks before providing care.
The provider ensured staff received training that met people's needs. Feedback showed people were happy with meals and the choice and quantity of food provided throughout the day. One person said, "[The food] its very good. Really tasty." People received support with their healthcare needs. The environment was maintained to meet people’s needs.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. We observed people were treated with compassion and kindness. People praised the way staff treated them with respect, maintained their dignity and promoted their day to day choices.
How to communicate effectively was recorded in care plans and staff were observed taking time to listen and respond appropriately to people. Activities were available for people to participate in. People were aware of how to raise any concerns should they have any complaints. When required, people were supported with their end of life needs.
Rating at last inspection and update:
The last rating for this service was inadequate (published 25 August 2020) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of all but one of the regulations.
This service has been in Special Measures since 25 August 2020. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We have found evidence that the provider needs to make improvement. Please see the Well-led section of this full report. The provider has taken action to lessen the risks identified during this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Coote Lane Residential Home on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified one breach in relation to good governance and the recording and auditing of information.
Please see the action we have told the provider to take at the end of this report.
Since the last inspection we recognised that the provider had failed to notify the commission without delay of an incident that occurred at Coote Lane Residential Home. This was a breach of regulation. Full information about CQC’s regulatory response to this is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Coote Lane Residential Care Home is a residential care home providing accommodation and personal care for up to 24 people aged 65 and over. There were 17 people living at the service at the time of the inspection. Some of the people lived with dementia and required support with their physical needs.
People’s experience of using this service and what we found
People told us they felt safe and staff were kind and caring. However, our observations showed that people did not always receive safe care and treatment. Staff had not reported safeguarding concerns to safeguarding authorities including repeated and unexplained injuries. People’s safety had been compromised due to the lack of adequate falls reductions measures being put in place. Risks to people were not always reviewed to identify ways to reduce repeat occurrences. People were at risk of harm from equipment and premises that were not inspected and maintained regularly. Risks of the spread of infections were not managed appropriately. People were offered their medicines in a safe manner however; improvements were required to the safe storage of medicines and record keeping.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. People told us staff sought their preferences, however, people’s ability to make decisions and to consent to care and treatment had not been assessed. The registered provider had not followed national guidance and best practice to support the effective delivery of care. People were not always supported by staff who had the right competences, induction and supervision to meet their needs. Staff supported people to have access to health professionals and specialist support. People were not offered a variety of choice on their daily meals.
The governance and quality checks in the home did not promote the delivery of safe care and treatment. The registered provider had not established good governance in line with best practice to improve the care delivered and to ensure compliance with regulations. There were no established policies to promote the effective delivery of care. The registered provider had not established robust oversight to support staff on the running of the service and compliance with regulations and to monitor people’s experiences.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for the service under the previous provider was Good, published on 2 November 2018. This is the first inspection of the service under this new provider.
Why we inspected
We received concerns in relation to the management of falls and safeguarding concerns. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to inadequate. This is based on the findings at this inspection.
Enforcement:
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to keeping people safe from preventable harm such as repeated falls, risk of fire, responding to changes in people’s needs, the safe maintenance of equipment and premises, seeking consent and poor governance at this inspection. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.