CQC report explained · a residential care home
What the CQC found at Coote Lane Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found safe medicines practice overall, safe recruitment, suitable staffing, infection controls and safeguarding arrangements. They noted that some people received pain relief earlier than the recommended four-hour interval, although maximum daily doses were not exceeded.
- Effective?
- Good
- People's needs and choices were assessed. Staff had induction, training and support. People had flexible meals, enough drinks and access to healthcare professionals.
- Caring?
- Good
- This question was not rated in this inspection report. Inspectors did report that people received person-centred support and were consulted about their care.
- Responsive?
- Good
- This question was not rated in this inspection report. The report says the home adapted meals and daily routines to people's preferences and supported relatives to contribute to care plans.
- Well-led?
- Good
- Inspectors found effective checks, audits and management arrangements. The provider had improved record keeping and was no longer in breach of Regulation 17.
What inspectors found, June 2023
Coote Lane Residential Home is rated Good; inspectors found safe, effective and well-led care, with one medicines timing issue to check.
Inspectors visited without warning on 6 June 2023. They spoke with people living in the home, relatives, staff and a visiting minister. They observed care, looked around the building and checked care, medicine, recruitment and management records.
The home was clean and hygienic. Medicines were generally stored and given safely. Staff were safely recruited, trained and available to meet people's needs. People had access to healthcare, food and drinks suited to their routines, and support that respected their choices.
The home was rated Good overall, with Safe, Effective and Well-led also rated Good. Caring and Responsive were not rated in this report. The previous rating was Requires Improvement, and inspectors said improvements had been made so the home was no longer in breach of regulations.
Infection control
Inspectors were assured that the home was clean, used protective equipment properly and had improved its infection prevention arrangements since the previous inspection.
“The home was clean and hygienic, and staff were seen to wear appropriate personal protective equipment (PPE).” from the report
Staffing and recruitment
The home completed appropriate checks before employing staff and arranged extra staff when people's needs or appointments required this.
“Systems were in place to ensure staff were recruited safely and records confirmed a range of checks including references, Disclosure and Barring checks (DBS) had been requested and obtained prior to new staff commencing work in the service.” from the report
Flexible food and routines
People could have meals, snacks and drinks around their own routines. Staff offered alternatives and saved meals when someone was asleep or not hungry.
“We don't stick to set times, if someone wants a lie in, I make breakfast when they want.” from the report
Management and improvement
Inspectors found a positive culture, regular checks and a management team that worked with other professionals to improve people's care.
“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.” from the report
Timing of pain relief
needs fixingSome people received pain relief sooner than the recommended four-hour interval. The maximum prescribed amount in 24 hours was not exceeded, but the manager said these incidents would be reviewed.
“However, some people had pain relief sooner than the recommended 4 hourly timed interval, although the prescribed maximum dosage for a 24 hour period was not exceeded.” from the report
Newer staff gaining experience
minorOne person said that one or two newer staff still needed to learn the role. They were being supported by more experienced staff, but families may want to ask how this is monitored.
“There are one or two new ones at present, and they need to learn, but you see them with the more experienced ones, being told what to do.” from the report
- 01What did you find when you reviewed the occasions when pain relief was given before the recommended four-hour interval?
- 02How do you check that newer staff have completed their induction and can meet each person's needs safely?
- 03How do you decide when extra staff are needed for appointments or to reduce identified risks?
- 04How are relatives asked to contribute to and review their family member's care plan?
- 05How will you maintain the improved infection prevention arrangements found at this inspection?
This was an unannounced inspection that rated Safe, Effective and Well-led; Caring and Responsive were not rated in this report, and infection prevention was specifically reviewed under Safe. This explanation was written from the published report of 24 June 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, July 2021
Rated Requires Improvement and no longer in special measures; inspectors found kind, responsive care but gaps in records, checks and infection-control practice.
This was an unannounced follow-up inspection on 04 June 2021. Two inspectors spoke with people, relatives and staff, observed the home, and checked care, medicine, recruitment and management records.
The home had improved since its previous Inadequate rating. Medicines were given safely, the home was clean, staffing and recruitment were suitable, and people described kind care, good food and support with their choices and health needs.
There were still important weaknesses. Some care plans lacked information, checks did not always find problems, unexplained injuries were not properly reported, and some staff did not follow the infection-control policy. The home was still in breach of Regulation 17 on good governance.
The overall rating was Requires Improvement. Safe, Effective and Well-led were Requires Improvement, while Caring and Responsive were Good. The home was no longer rated Inadequate or placed in special measures.
Kind and respectful care
People were treated with patience and kindness. Staff respected privacy, dignity, choices and individual routines.
“We observed staff were patient and considerate with people.” from the report
Flexible meals and choices
People could choose what to eat, where to eat and when to have meals or drinks. Inspectors found people were positive about the food.
“There were no set mealtimes, we observed people arriving in the dining room at different times and choosing where they sat and who with.” from the report
Medicines managed safely
Trained staff gave medicines correctly and in a personalised way. Allergies and special dietary needs were recorded for staff to see.
“People's medicines were administered correctly. When people were allergic to specific medicines, this was identified on their medicine administration records.” from the report
Improvement since the previous inspection
The service improved from Inadequate and left special measures. The provider was no longer in breach of most of the regulations identified previously.
“At this inspection we found improvements had been made and the provider was no longer in breach of all but one of the regulations.” from the report
Weak quality checks and records
seriousAudits did not find missing care-plan information, incomplete medicine-fridge temperature records or an unexplained injury that had not been recorded and reviewed. This was a continued breach of Regulation 17.
“We found no evidence that people had been harmed however, systems were either not in place or robust enough to demonstrate safety was effectively managed. This placed people at risk of harm.” from the report
Unexplained injuries not reported
seriousOn two occasions, unexplained bruising and a cut to one person’s hand were not properly reported, investigated or discussed with the local authority.
“On two occasions one person had unexplained bruising and an unexplained cut to their hand. The provider had not been made aware of these concerns and investigated these concerns and discussed the outcome with the local authority.” from the report
Care plans missing important information
needs fixingSome care plans did not explain people’s behaviours, health conditions or what staff should do if health deteriorated. The provider said these plans were updated during and after the inspection.
“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.” from the report
Infection-control practice
needs fixingSome staff travelled to and from work in their uniforms instead of changing at the home. Inspectors recommended that the provider follow good practice guidance on infection prevention and control.
“Some staff did not follow the providers infection prevention and control policy. Despite having an allocated area for changing, some staff travelled to and from work in their uniforms.” from the report
- 01What changes have been made to care plans, and how do you check they contain current risks, health conditions and guidance for staff?
- 02How are unexplained injuries recorded, investigated and reported to the local authority?
- 03How often are medicine-room and medicine-fridge temperatures checked, and who reviews the records?
- 04How do you make sure all staff change out of their uniforms at the home and follow the infection-control policy?
- 05Has the new manager applied for CQC registration, and what oversight is now in place while this is completed?
This was an unannounced follow-up inspection covering all five key questions, with infection prevention and control also checked as part of the Safe assessment. This explanation was written from the published report of 14 July 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 Coote Lane Residential Home
5 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- June 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2021Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- August 2020Inspected but not ratedSafe: InadequateEffective: InadequateWell-led: Inadequate
- November 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- August 2019
Registered with the Care Quality Commission on 6 August 2019.
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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85 live-in carers within about an hour of Lancashire
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 £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
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.