CQC report explained · a residential care home
What the CQC found at 37 Coleraine Road
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People and relatives said they felt safe, and inspectors found enough staff, suitable risk assessments, trained staff and safe medicines systems. Two fire safety action points were completed during and after the inspection.
- Effective?
- Good
- Staff had relevant training, regular supervision and support. People were supported with food, drink, healthcare and decision-making, although some additional food given for weight gain was not recorded in daily care logs.
- Caring?
- Good
- Inspectors observed positive relationships and a calm atmosphere. People said staff listened to them, respected their privacy and dignity, and encouraged them to remain independent.
- Responsive?
- Good
- Care plans were detailed and regularly reviewed, and staff understood people's preferences, communication needs and cultural or religious needs. People were supported with personalised activities and complaints were recorded and addressed.
- Well-led?
- Good
- The management was described as approachable and improvements had been made since the previous inspection. Audits, feedback meetings and action plans were used to monitor and improve the service.
What inspectors found, April 2018
37 Coleraine Road was rated Good overall; inspectors found safe, caring and personalised support, with end-of-life training still needed.
Inspectors visited without warning on 14 and 19 March 2018. They met people living at the home and people using the supported living service, spoke with staff, relatives and healthcare professionals, and checked care plans, medicines, staff records, complaints and safety records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People and relatives said they felt safe, staff were kind and respectful, and people's needs, choices, activities and independence were supported.
The provider had improved its records and care planning since the previous inspection. The earlier breach about good governance had been corrected, so the provider was no longer in breach of a legal requirement.
Inspectors found that staff had not been trained in end-of-life care. They recommended that the provider seek guidance about this. They also noted that some additional food given for weight gain was not recorded in daily care logs.
Safe staffing and risk support
Inspectors found enough staff and individual risk assessments that explained how to keep people safe. Staff understood safeguarding and knew how to report concerns.
“There were sufficient numbers of suitable staff to provide safe care.” from the report
Kind and respectful care
People and relatives described staff as caring and friendly. Inspectors saw positive interactions and a calm atmosphere.
“We observed relaxed atmosphere where staff and people shared positive working relationships.” from the report
Personalised support
Care plans included people's histories, preferences, health needs and communication methods. Staff supported people to make choices and build daily living skills.
“This demonstrated people received care that was person-centred and responsive to their needs.” from the report
Improved management
The provider had improved care records, risk assessments and monitoring since the previous inspection. Management sought feedback from people, relatives and staff.
“We found the service had reviewed and updated people's care plans and risk assessments.” from the report
End-of-life training
needs fixingStaff had not been trained in end-of-life care. Inspectors recommended that the provider seek advice and guidance about suitable training.
“We found staff had not been trained in end of life care.” from the report
Recording special dietary support
minorFood recommended to help one person gain weight was being provided but was not recorded in the person's daily care logs. The manager said this would be recorded in future.
“However, they did not record this in the person's daily care logs.” from the report
- 01What end-of-life care training have staff completed since this inspection?
- 02How do you record extra food and drinks provided for people's health or weight gain?
- 03How often are care plans and risk assessments reviewed, and how are relatives involved?
- 04How are activity plans matched to each person's interests, goals and communication needs?
- 05How do you check that lessons from accidents, safeguarding concerns and complaints are acted on?
This unannounced inspection looked at the care home and at personal care and support in two supported living settings; it found Good ratings in all five areas. This explanation was written from the published report of 20 April 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, August 2017
Rated Requires Improvement; inspectors found kind and responsive care, but gaps in risk records, staff support and quality checks created safety concerns.
This was an unannounced comprehensive inspection on 9 March 2017. Inspectors observed care, spoke with people, relatives, staff and healthcare professionals, and checked care records, medicines records, staff files and management records.
The home was rated Good for Caring and Responsive. People were treated with dignity, supported to make choices and encouraged to be independent. They had activities, community outings and support to maintain relationships.
The home was rated Requires Improvement for Safe, Effective and Well-led. Inspectors found missing or outdated records, including information about choking risks and people's health needs. Staff supervision was not regular enough, not everyone subject to restrictions had appropriate DoLS arrangements, and quality checks had not found the problems.
There had been some improvements since the focused inspection in April 2016. These included buying a people carrier, adding a floating support worker and buying a portable ramp. However, some record-keeping problems found in 2016 were still present.
Safeguarding and recruitment
Staff knew how to recognise and report abuse. The required recruitment checks had been completed.
“People were protected from the risk of abuse because staff were knowledgeable and knew what action to take to protect people.” from the report
Respectful care
Inspectors saw staff speaking respectfully to people and respecting their privacy, views and dignity.
“People were treated with dignity and respect.” from the report
Activities and independence
People were supported to take part in activities, go into the community and develop independence.
“The service had invested in a new people carrier following our last inspection in April 2016 to take people out into the community.” from the report
Choice and nutrition
People were offered choices about food and drink. The home had specialist food guidance and equipment for one person's dietary needs.
“People's nutritional needs were being met and people were given choice.” from the report
Choking risk records
seriousOne person did not have a suitable choking risk assessment. Another assessment did not include the specialist guidance needed to reduce the risk of unsafe care.
“Therefore, records were not accurate and up to date which put the person at risk of receiving care that was inappropriate or unsafe.” from the report
Outdated health records
seriousHealth action plans were still not up to date, despite this being identified at the previous inspection. A risk assessment had also not been updated after healthcare advice.
“HAPs for people using the service had still not been updated and a risk assessment for one person had not been updated to reflect recommendations made by a healthcare professional.” from the report
Ramp training
needs fixingStaff struggled to use the portable ramp safely, and some staff had not been trained to use it. The provider said further training would be given.
“Some staff had not received training in how to use the ramp.” from the report
Staff supervision
needs fixingStaff did not receive supervision as often as the provider's policy required. A new supervision plan had started by the time of the inspection.
“Staff supervision had not taken place in line with the provider's policy and procedures.” from the report
Quality monitoring
seriousThe home's checks did not identify the record-keeping problems. The report says this was a breach of Regulation 17.
“Systems for monitoring the quality of service were not effective in identifying the concerns found at this inspection.” from the report
- 01Have all health action plans, care plans and risk assessments now been updated, especially the choking assessment and specialist eating and drinking guidance?
- 02How do you make sure every staff member is trained and assessed as competent to use the portable ramp?
- 03Are staff now receiving supervision at least once every two months, as stated in the provider's policy?
- 04Have all restrictions on people's liberty been checked to make sure the correct DoLS or other legal arrangements are in place?
- 05What quality checks are now used to find missing or outdated records before they affect people's care?
This was an unannounced comprehensive inspection covering all five key questions for the home, with records also reviewed for two people using the service. This explanation was written from the published report of 11 August 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of 37 Coleraine Road
5 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- April 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2015Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2014
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- May 2011
Registered with the Care Quality Commission on 13 May 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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At least 100 live-in carers within about an hour of Haringey
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Most charge £980 to £1,260 a week. 75 can care for a couple. 11 years' experience on average.
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