CQC report explained · a residential care home
What the CQC found at Coralyn House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, March 2020
Rated Requires Improvement; inspectors found kind and personalised care, but safety checks, staff recruitment and management systems were not reliable enough.
This was an unannounced inspection by two inspectors. They observed care and staff interactions, spoke with staff and the provider, reviewed care and medicines records, and contacted a health professional after the visit.
The home supported four people with learning disabilities. Inspectors found risks from very hot taps, unsafe windows and unstable wardrobes. Kitchen surfaces were worn and cracked. One bank worker had not had the correct recruitment checks, and some part-time staff had not completed adequate training.
People received their medicines safely, had enough food and drink, and could access health professionals and community activities. Staff were kind, respectful and promoted independence. However, the home did not have strong enough systems to identify and fix problems, and it had not improved enough since the previous inspection.
The overall rating was Requires Improvement. Safe, Effective and Well-led were also Requires Improvement. Caring and Responsive were Good. The report says there were breaches of regulations and that the provider must send an action plan.
Kind and respectful staff
Inspectors saw caring interactions. Staff used people's preferred names, offered reassurance and encouraged independence.
“Staff were respectful and patient when interacting with people.” from the report
Personalised support
Care plans contained detailed information about people's needs, preferences, routines, likes and dislikes. Staff knew people well.
“People received personalised care and support specific to their needs and preferences.” from the report
Medicines managed safely
Medicines were given as prescribed. Staff had training and guidance for medicines taken only when needed.
“We saw that medicine administration was completed in accordance with good practice.” from the report
Access to health support
Staff recognised changes in people's needs and sought advice from health professionals. Records helped professionals provide timely support.
“Staff could promptly identify when people`s needs changed and sought professional advice.” from the report
Environmental safety risks
seriousInspectors found hot taps that could cause burns, unsafe windows, unstable wardrobes and kitchen surfaces that could not be cleaned properly. These risks had not been identified by the provider.
“Water coming from these taps was excessively hot and could cause skin burns.” from the report
Recruitment checks
seriousA bank worker did not have a recent DBS check from this employment, and the provider did not apply the same checks to all part-time or bank workers.
“DBS checks are not portable, and a new check should be undertaken at the commencement of employment.” from the report
Incomplete staff training
needs fixingOne bank worker had not completed training at the home, and there was no record that their induction had been completed. Their previous social care training was more than five years old.
“for one member of bank staff, there were no records to confirm that this had been completed.” from the report
Weak management checks
seriousThe provider's audits and environmental checks were not robust enough to find important risks. There was still no formal development plan to address earlier concerns.
“Systems for monitoring and improving the quality and safety of the service were not operating effectively.” from the report
Limited best-practice knowledge
needs fixingThe provider had not undertaken further training or joined networks to improve knowledge of supporting people with learning disabilities. Staff were not aware of the Registering the Right Support guidance.
“The provider had not yet engaged in any further training or development for themselves or their staff team in this area.” from the report
- 01Have the hot water taps, window restrictors, unstable wardrobes and worn kitchen surfaces all been repaired, and how are these checks recorded now?
- 02Has every bank and part-time worker had the required recruitment checks, including a current DBS check?
- 03What training and induction must bank staff complete before working with residents, and how do you check this?
- 04What formal improvement plan is now in place, with dates and named responsibilities, to address the continued breaches?
- 05How are residents' meetings run now to make sure they focus respectfully on residents' views and needs?
This was a planned inspection based on the previous rating and covered all five CQC questions, including the care provided and the premises. This explanation was written from the published report of 13 March 2020 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, April 2019
Coralyn House was rated Requires Improvement; inspectors found safety risks, disrespectful interactions and weak checks on quality and improvement.
The inspection took place over three visits in March 2019. One inspector spoke with people living at the home, relatives, staff, the manager and a professional. They also observed care and checked care records, risk assessments, medicines, recruitment, training and quality systems.
The home was rated Requires Improvement in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found risks that were not always managed, including unsafe food preparation for someone at risk of choking, very hot radiators and poor cleaning. Staff did not always interact respectfully or promote independence.
There were also positive findings. People received their medicines as needed, staffing levels were sufficient, recruitment was safe, and people were supported with healthcare, food and drink. However, the home needed better staff training, more personalised care, improved communication support and stronger systems to identify and fix problems.
The previous rating was Good, published in April 2016. The report says there were breaches of regulations about safe care, the premises and good governance. The provider was required to send the CQC a report explaining what action it would take.
Medicines
People received their medicines when they needed them. Records, storage, staff training and competency checks were in place.
“People received their medicines when they should.” from the report
Staffing and recruitment
Inspectors found enough staff to meet people's needs, and recruitment checks continued to be effective.
“There were enough staff to meet people's needs and staff had time to spend with people to ensure their well-being.” from the report
Healthcare support
People were supported to maintain their health, and medical appointments were recorded.
“People were supported to maintain good health and medical appointments were recorded.” from the report
Food and choice
People could choose what to eat and were offered alternatives when they did not want the planned meal.
“Where people did not want what was on the menu, they were supported to have something different.” from the report
Choking risk
seriousA person at risk of aspiration was seen eating food that did not follow specialist recommendations. The relevant information was also missing from the care records.
“Staff were not following these recommendations and this information was not in the care records.” from the report
Environmental safety and condition
seriousVery hot radiators created a possible scalding risk. The home also needed redecoration, and the shower was difficult to use and grubby.
“Three radiators in the service including two in people's bedrooms were very hot to touch.” from the report
Respect and independence
needs fixingInspectors saw staff using language and gestures that were not always respectful. People were not consistently offered choices or encouraged to help with daily tasks.
“We observed the interaction of the staff was not always appropriate or respectful.” from the report
Training and communication
needs fixingFurther training was needed in complex behaviours and choking. Staff did not always use the communication tools set out in a person's support plan.
“Further training was required around supporting complex behaviours and the risk of choking to ensure staff could meet people's individual and specific needs.” from the report
- 01What action has been taken to make sure specialist food and choking guidance is followed and recorded in each person's care plan?
- 02How have the hot radiators, damaged decoration and shower cubicle been repaired or replaced?
- 03What training have staff completed on choking, complex behaviours and respectful communication?
- 04How do you now record incidents, complaints and feedback, and show that changes have been made?
- 05How are people supported to make choices, take part in daily tasks and access more activities in the community?
This was a planned inspection covering all five CQC questions, based on the previous rating; it included announced and unannounced visits and additional evidence requested afterwards. This explanation was written from the published report of 19 April 2019 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 Coralyn House
4 rated inspections over 4 years: the service has held its Requires improvement rating throughout.
- March 2020Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- March 2014
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- April 2011
Registered with the Care Quality Commission on 18 April 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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