Archived: Coach House Nursing Home

Updated 26 July 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

This inspection was completed by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type:

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. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodates up to 17 people. At the time of our visit there were 16 people lived there, however one person had been admitted to hospital on the day of our inspection.

The service had two managers who job shared and were registered with the Care Quality Commission, one of whom was also the registered provider. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

This inspection was unannounced.

What we did before the inspection:

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We reviewed other information that we held about the service such as notifications. These are events that happen in the service that the provider is legally required to tell us about.

During the inspection:

We spoke with five people who lived at the service and two people’s relatives. We also spoke with five members of staff. This included the registered managers, nursing staff and care staff. We reviewed a sample of people’s care and support records. We also looked at records relating to the management of the service such as incident and accident records, meeting minutes, training records, policies, audits and complaints. After the inspection we contacted healthcare professionals who worked with the service. We received feedback from five professionals giving their views of Coach House Nursing Home.

Updated 26 July 2019

About the service:

Coach House Nursing Home is a nursing home that provides accommodation with nursing and personal care for up to 17 people. When we visited, 16 people lived there. However, one person had been admitted to hospital on the day of our inspection.

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

People were supported by staff that were caring and treated them with dignity and respect. Staff understood the needs of the people they supported well and knew them as a person. Through conversation, staff told us how they aimed to achieve positive outcomes for people. All the feedback we received from people, their relatives and healthcare professionals was positive.

Risks of abuse to people were minimised. Assessments of people’s needs identified known risks and risk management guidance was produced for staff which they understood. We found improvements could be made in relation to the management of some people’s specific medical conditions. The service had appropriate safeguarding systems and processes. Staff understood safeguarding reporting processes

Although people received their medicines as prescribed, improvements were needed in relation to the safe management of known risks and the storage of medicines. There were effective systems that ensured the service was safe. Health and safety checks, together with effective checks of the environment were carried out by dedicated staff.

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. There were systems in place that ensured people who were deprived of their liberty were done so with the appropriate legal authority. We identified that the service needed to make improvements in how they applied the principles of the Mental Capacity Act 2005 and associated guidance. We have made a recommendation about this within the report.

People were supported by staff who had the skills and knowledge to meet their needs. Staff felt supported by the registered managers, however the registered manager told us, and records confirmed, that staff supervision and appraisal had fallen behind. Staff understood their role and were confident when performing it through a continual training package. Staff at the service worked together with a range of healthcare professionals to achieve positive outcomes for people and followed professional advice to achieve this.

People’s care plans were inconsistent in relation to the personalised information they held. Whilst it was evident staff knew people, this did not evidence a fully person-centred approach to care planning. The provider had identified this and was taking action to improve care plans. The provision of activities within the service was limited, and we have made a recommendation about this.

Since 2016 onwards all organisations that provide publicly funded adult social care are legally required to follow the Accessible Information Standard (AIS). The standard was introduced to make sure people are given information in a way they can understand. One registered manager of the service was not aware of the AIS. Whilst it was not evident there was any impact to people at the time of inspection, we have made a further recommendation about this.

People's concerns and complaints were listened to and responded to. Accidents, incidents and complaints were reviewed to learn and improve the service. People and their relatives commented positively about the registered managers and the quality of care their family member received. No concerns were raised about the quality of care provided.

Quality monitoring systems included audits and regular checks of the environment to ensure people received the right care. We found these had not been fully effective in identifying the shortfalls found at this inspection.

Rating at last inspection:

The service was registered with us in May 2018 and this is the first inspection.

Why we inspected:

This was a planned inspection.

Follow up:

We will continue to monitor the service through the information we receive. We will inspect in line with our inspection programme or sooner if required.

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