Archived: BLHC Coote Lane Limited

Updated 2 November 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 25 September 2018 and was unannounced.

The inspection was carried out by one adult social care inspector and an expert by experience. An expert-by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

During this inspection we spoke with 15 people living at the home and eight visiting relatives. We looked at the care plans files and medicines records for the people living in the home and at seven people’s care records in greater detail. We observed the care and support staff provided to people in the communal areas of the home and at meal times. We observed medicines being handled and discussed medicines handling with the staff involved.

We spoke with four care staff and a senior staff member. The registered manager was on annual leave and we spoke with them on their return. We reviewed five recruitment files, two belonging to staff members who had been recruited since the last inspection. We checked documentation that was relevant to the management of the service including quality assurance and monitoring systems.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed the information we held about the service. We contacted health and social services commissioners who contracted people’s care. We also contacted the local safeguarding and adult social services teams. We spoke with health care professionals who supported people who lived in the home.

We checked the information we held about statutory notifications sent to us about incidents and accidents affecting the service and people living there. A statutory notification is information about important events that the provider is required to send to us by law. We used a planning tool to collate all this evidence and information prior to visiting the home.

Updated 2 November 2018

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 part in and people were also supported to follow individual interests and hobbies.

We have made a recommendation that the service looks at ways of how technology can be used to enhance people’s lives.

Staff were caring and treated people with dignity and respect and ensured people's privacy was maintained particularly when being supported with their personal care needs.

People were provided with meals and drinks that they enjoyed. The staff were knowledgeable about the support people required to enjoy their meals and drinks safely and this was provided.

The home had undergone improvements to the environment since the last inspection. The registered manager and owner had developed an improvement plan for the home which included the next phase of works, such as continuing to replace furniture and carpets.

The service had audits and checks in place on the premises and quality of the service including seeking people's views. Concerns and complaints were managed appropriately.

The management structure in the home had been strengthened since the last inspection, including the appointment of a new registered manager. This had led to improvements in the service, such as with care planning and the thoroughness of audits. Staff morale, team work and communication had also improved and the staff team were very positive about the changes.

Further information is in the detailed findings below.