The Coach House Nursing Home

Updated 6 February 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 11December 2017 and was unannounced. A second day of inspection took place on 14 December 2017 which was announced.

The inspection team consisted of one inspector, a specialist nurse advisor and an expert-by-experience. The specialist advisor who supported this inspection was a specialist in nursing care. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of service.

The provider completed a Provider Information Return (PIR) as part of the Provider Information Collection. We used information the provider sent us in the PIR. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We sought feedback from the commissioners of the service and Healthwatch prior to our visit. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

Before our inspection, we reviewed information we held about the service, which included information shared with the CQC including whistleblowing and notifications sent to us since our last inspection. Whistleblowing is where people can disclose concerns they have about any part of the service where they feel dangerous, illegal or improper activity is happening. Notifications are when providers send us information about certain changes, events or incidents that occur and which affect their service or the people who use it.

During our inspection we spent time observing care and support provided to people in the communal areas of the service. We spoke with eight people who used the service, six relatives, the registered manager, the owner, two nurses, four care staff, the chef, the house keeper and activities co-ordinator.

We looked at five people's care records and other records relating to the management of the home. These included three staff recruitment records, duty rosters, accident and incidents, complaints, health and safety, maintenance, quality monitoring and medicines records.

During our inspection, we spoke with two health and social care professionals for their feedback on their experiences of the care provided.

Updated 6 February 2018

The inspection took place on 11December 2017 and was unannounced. A second day of inspection took place on 14 December 2017 which was announced.

The Coach House Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The Coach House Nursing Home is registered to provide accommodation for persons who require nursing and/or personal care for up to 42 people. This may also include palliative and respite care. There were 40 people living at the service on the day we inspected.

The care home is a large detached property situated in its own grounds. Accommodation is provided over three floors and there are two passenger lifts for people who have reduced mobility.

At the last inspection, the service was rated good. At this inspection we found the service remained good.

There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about different types of abuse and were aware of action they should take if abuse was suspected.

Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety.

People were protected by a robust recruitment process, which ensured staff were suitable to work with people who needed support.

People received their prescribed medicines safely. Medicines were administered by staff who were trained and assessed as being competent to do this.

Staffing levels were sufficient to meet people's needs and to enable them to do be supported in a way that they wished. Staff received support and training to give them the necessary skills and knowledge to meet people's assessed needs.

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

Risks to people's safety had been assessed by staff and regularly reviewed to ensure they contained up to date information. Care plans included information about how people preferred to be supported.

People's independence was encouraged and there were a range of activities and events people could participate in.

We saw positive interactions between people and staff and people told us they were happy and felt well cared for. Staff treated people with dignity and respect. They knew people well and respected their individuality.

We saw people were provided with a choice of healthy food and drinks which helped to ensure their nutritional needs were met. People were supported to maintain good health and had access to healthcare professionals and services.

The provider had a system in place for responding to people's concerns and complaints. People were regularly asked for their views and there were effective systems in place to monitor and improve the quality of the service provided.

Further information is in the detailed findings below.