CQC report explained · a nursing home
What the CQC found at Coast Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were generally assessed and managed, medicines were administered safely, staffing levels were sufficient and the home was clean. Some missing risk assessments were found and addressed during the inspection.
- Effective?
- Good
- This question was not covered by this focused inspection. Its previous rating was carried forward, but the report does not state that rating in the inspected sections.
- Caring?
- Good
- This question was not covered by this focused inspection. Its previous rating was carried forward, but the report does not state that rating in the inspected sections.
- Responsive?
- Good
- Care was provided in a person-centred way. People were supported with communication, activities, personal interests and end of life care, and complaints were recorded and followed up.
- Well-led?
- Requires improvement
- The home had a positive culture and improved monthly checks, but some risk assessments, mental capacity assessments and care records were incomplete or not sufficiently detailed.
What inspectors found, January 2023
Rated Good overall, but inspectors found that the home’s leadership and records still required improvement.
Inspectors made an unannounced focused inspection visit on 8 December 2022. They spoke with people, relatives, staff and health and social care professionals. They also reviewed care plans, risk records, medicines records, staff files, complaints and quality checks.
The home was rated Good for Safe and Responsive. People told inspectors they felt safe. Staff supported people with medicines, communication, activities and end of life care. The home was clean, there were enough staff during the inspection, and complaints were now recorded and handled more consistently.
The home was rated Requires Improvement for Well-led. Some risk assessments, mental capacity records and one care plan were incomplete or lacked enough detail. The registered manager took immediate steps to address these issues, but the home’s checking systems had not found all the gaps.
The previous overall rating was Requires Improvement, with breaches of regulation. Inspectors found enough improvement for the home to no longer be in breach, and the overall rating changed to Good. This inspection only assessed Safe, Responsive and Well-led. Other ratings carried over from the previous inspection.
People felt safe
People and relatives told inspectors they felt safe. Staff could explain how they recognised and reported safeguarding concerns.
“People and their relatives told us they felt safe.” from the report
Safe medicines support
Medicines were administered by trained staff, recorded on medicine charts and stored securely. Procedures were also in place for medicines given when needed.
“Medicines were administered safely.” from the report
Person-centred care
Care plans included people's preferences, abilities and support needs. Staff were able to describe people’s routines and how they supported independence.
“Care plans were held and updated on a computer programme and were person centred.” from the report
Activities and relationships
The home had an activities co-ordinator and enough staff to provide group or one-to-one activities. People could personalise their rooms and spend time on their interests.
“There were enough staff available each shift to enable them to spend time with people doing activities or simply talking with people about their interests.” from the report
Improved complaints handling
Complaints were recorded with actions and outcomes. People and relatives were told about investigations, and the complaints policy was accessible.
“Complaints about the service had been recorded in line with their service policy.” from the report
Missing risk assessments
needs fixingSome risks linked to medicines, diabetes and wound care did not have documented or thorough assessments. The manager completed the missing assessments after inspectors raised this.
“Not all risks had been documented or had thorough risk assessments in place.” from the report
Incomplete mental capacity records
needs fixingSome mental capacity assessments were not specific to the decision being made. Records did not always show who had taken part in best interest decisions.
“It was not always clear who was involved in best interest decisions with no record of the person, their relatives or advocate or professionals being involved in the decisions.” from the report
One care plan lacked detail
minorOne care plan contained very little information about the person’s care and support needs. Staff knew the person well, and inspectors found no immediate safety risk.
“One care plan contained very little detail about the person.” from the report
Home checks had not found all gaps
needs fixingThe home had improved its auditing, but its own checking process had not identified all the missing assessments and record problems. Inspectors said these areas still needed improvement.
“The provider's auditing processes had not identified this.” from the report
- 01Have all risk assessments for medicines, diabetes and wound care now been completed and checked?
- 02How do you make sure mental capacity assessments are specific to each decision?
- 03How do you record who was involved in best interest decisions?
- 04What checks are now in place to make sure every care plan contains enough detail?
- 05How will you monitor that the improvements in auditing and record keeping remain in place?
This was an unannounced focused inspection of Safe, Responsive and Well-led; the other ratings were carried forward from the previous inspection. This explanation was written from the published report of 6 January 2023 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, February 2021
Coast Care Centre is rated Requires Improvement; inspectors found kind care and enough staff, but serious gaps in medicines, risk plans and checks.
Inspectors visited without notice on 15 and 16 December 2020. They spoke with people, relatives, staff and professionals, observed care, and checked care plans, medicines, recruitment, safeguarding, accidents and management records. Infection prevention was also checked because of the COVID-19 pandemic.
People were generally treated kindly and with respect. Staff knew people well, there were enough trained staff on each shift, safeguarding arrangements had improved, and infection control measures were effective. The effective and caring areas were both rated Good.
However, some people with diabetes did not have clear risk plans. Staff lacked guidance about low blood sugars and refused medicines. There were also missing medicine protocols, poor records about pain relief, and inaccurate or incomplete care plans. Complaints and concerns were not consistently recorded or investigated.
The overall rating is Requires Improvement. Safe, responsive and well-led were rated Requires Improvement. The provider remained in breach of Regulations 12 and 17, although safeguarding arrangements and accident follow-up had improved since the previous targeted inspection.
Kind and respectful care
People and relatives described staff as kind and supportive. Inspectors saw staff taking time to reassure people, protect their dignity and encourage independence.
“People were well cared for and we observed several positive interactions between staff and people.” from the report
Staffing and recruitment
There were enough trained staff on each shift. Recruitment checks included employment histories, references, DBS checks and nursing registration checks.
“There were always enough trained staff covering each shift.” from the report
Infection control
Inspectors found effective arrangements for PPE, testing, isolation, visiting controls, cleaning and social distancing during the pandemic.
“We were assured that the provider was using PPE effectively and safely.” from the report
Food and nutrition
People's weights and nutritional risks were monitored. Staff knew dietary needs, offered meal choices and used modified diets where required.
“People's nutritional needs were met.” from the report
Improved safeguarding and incident follow-up
Safeguarding investigations and accident follow-up had improved since the previous inspection. Staff knew how to report concerns and serious incidents were escalated.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 13.” from the report
Medicines and pain relief
seriousRecords did not show when refused medicines were offered again. Some PRN medicines lacked protocols, and staff did not consistently monitor whether pain relief was effective, including for people nearing the end of life.
“There was no consistent approach to monitoring the effectiveness of the pain relief such as a pain chart.” from the report
Limited end of life training
needs fixingNursing staff had relevant training through their nursing education, but other staff had not received end of life training. The home planned to provide this.
“The rest of the staff at the service had not received end of life training.” from the report
- 01What specific care plan and monitoring will be in place for my relative's diabetes, including low blood sugar and refused medicine?
- 02How will you record medicines that are refused, including when they are offered again?
- 03What PRN medicine protocols and pain monitoring will be in place for my relative?
- 04How will you make sure care plans accurately reflect changing needs, mobility goals and end of life wishes?
- 05How can I see the complaints policy, and how will you record and respond to any concerns I raise?
This was an unannounced planned inspection of all five key questions, including infection prevention and control, following an earlier targeted inspection; the visit time was limited because of COVID-19. This explanation was written from the published report of 3 February 2021 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 Coast Care Centre
2 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- January 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2021Requires improvementSafe: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2020Inspected but not ratedSafe: Inspected but not ratedWell-led: Inspected but not rated
- May 2020
Registered with the Care Quality Commission on 1 May 2020.
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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19 live-in carers within about an hour of East Sussex
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,000 to £1,400 a week. 13 can care for a couple. 10 years' experience on average.
“When he point blank refused to go into hospital for a life saving blood transfusion she talked him through the situation and agreed to go in the ambulance with him and stayed until he was settled.”
“Una felt safe, secure and loved in her time with Debbie which is a gift that I am eternally grateful for.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.