Coralyn House

Updated 13 March 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Coralyn House 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.

This inspection was unannounced.

What we did before the inspection

We reviewed information we received from the service by way of notifications. Notifications are required by law and identify incidents that had happened in the service and the actions taken in response, including safeguarding and serious injury.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We carried out observations of how people received their care and support as well as staff interactions. We spoke with the registered manager who is also the registered provider, a senior support worker and a support worker.

We reviewed a range of records. This included two people’s care records and medicine records. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

After the inspection

We spoke with one professional who had been recently involved with the service. We continued to seek confirmation and clarification from the provider to validate evidence found.

Updated 13 March 2020

About the service

Coralyn House is a residential care home providing accommodation and personal care to four people with a learning disability at the time of the inspection. The service can support up to five people in one residential property.

People’s experience of using this service and what we found

People were not protected in a safe environment. We identified risks in the environment which had not been recognised or addressed by staff or the provider. Staff had not all been recruited in line with regulations. There were enough staff on duty to meet peoples needs. Improvements had been made to meet the needs of people whose behaviour may challenge. Staff knew how to report any safeguarding concerns and had completed training in this. People received their medicines as the prescriber intended, robust systems supported this. Improvements needed to be made to the condition of surfaces in the kitchen to promote better infection prevention and control.

The environment of the home needed improving, redecoration of the home since our previous inspection where we identified this had been very limited. People had enough to eat and drink, where people were at risk of not maintaining healthy nutrition, staff worked with professionals to improve this. The registered manager ensured people had access to health professionals when required. Staff told us they received training in essential areas such as health and safety, but we found that part time staff had not undertaken adequate training.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff were kind and caring and encouraged people to promote their independence. Staff were respectful and courteous in their interactions with people, although residents’ meetings needed to be more respectful and focussed on the views and needs of people.

People were able to undertake activities of their choice and use facilities in the community. Improvements had been made in ensuring the accessible information’s standards were followed. Staff were working with people to explore any wishes or preferences they wanted considered at the end of their lives.

The service didn’t consistently apply the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The provider did not fully understand these principles and had not undertaken additional training to further develop their knowledge to ensure they followed best practice guidance in supporting people with a learning disability.

There was a lack of clear governance in the service and the provider did not have effective systems in place to consistently assess, monitor and improve the quality of care. This meant safety issues were not identified and rectified by the provider. The service has not sufficiently improved since our last inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update) The last rating for this service was requires improvement (published 23 April 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, sufficient improvement had not been made and the provider was still in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to safe care and treatment, fit and proper persons employed, premises and equipment, and good governance.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.