Coach House Nursing Home

Updated 9 June 2022

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of two inspectors and a specialist advisor.

Service and service type

Coach House nursing home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Coach House nursing home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 12 April 2022 and ended on 13 April 2022. We visited the location's service on 12 April 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection and sought feedback from the local authority. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We spoke with six members of staff including the Registered Manager, clinical lead, chef, care staff and an agency member of care staff. We spoke with five people and four relatives about their experiences of care and reviewed a range of care records. This included three people's care plans, a number of medication records and monitoring charts, and a variety of records relating to the management and governance of the service.

Updated 9 June 2022

About the service

Coach House Nursing Home is a care home providing personal and nursing care to up to 17 people. The home provides support to both older and younger adults with physical disabilities. It also provides end of life care. At the time of our inspection 13 people lived at the home. The care home accommodates people in one building which is situated in large, private grounds. The grounds and gardens are well maintained which people have access to and there is a pond with ducks, geese and swans.

People's experience of using the service and what we found.

People told us they felt safe at Coach House Nursing Home. Staff were trained in safeguarding and understood their responsibility to protect people from avoidable harm and abuse. Risks to people's health and safety were assessed with guidance for staff to follow. Staff were recruited safely and there were enough staff to provide safe and effective care. Overall, medicines were ordered, stored and administered safely in line with people's prescriptions. Accidents and incidents were reported and recorded and there was a new system to audit these for trends or patterns. We were assured by the infection, prevention and control measures.

Assessments of need were carried out prior to people moving in. This information was used to develop care plans. Staff were allocated to work in pairs according to their knowledge, skills and experience and staff gave positive feedback about their training. The chef was aware of people’s specific likes and dislikes, allergies and other dietary requirements and we received positive feedback from people and their relatives about the quality of food. Relatives gave positive feedback about people being well nourished. People received external, specialist healthcare support when they needed it. The Coach House Nursing Home provided a homely and warm environment and people were encouraged to decorate their bedrooms with personal pictures, ornaments and artefacts. Staff worked within the principles of the Mental Capacity Act . When people were identified as potentially being deprived of their liberty, applications were made to the authorising body.

People told us they felt cared for because staff were attentive and considerate when they needed support. Care staff told us the registered manager demonstrated the caring values of the home. People in bed looked well cared for and people told us staff were respectful when talking to them or providing them with care.

Care was planned in partnership with people and their views sought regularly, including through resident's meetings and reviews. The registered manager invested in accessible technology to support people and staff to communicate effectively with each other. Each person had a person-centred activity plan to ensure they were given opportunities to involve themselves in hobbies and interests of their choice. There was information about how people could raise a complaint displayed within the home. The registered manager worked with the local hospice to ensure training in end of life and palliative care was provided by someone with specialised skills and knowledge.

There were new systems to monitor the safety of the service. More time was needed for these processes to embed and become effective systems of quality assurance. Everyone we spoke with knew who the registered manager was. People were given the opportunity to make decisions and have choices about their lives at The Coach House Nursing Home during monthly ‘residents meetings’. Staff felt motivated by the registered manager to provide high standards of care. The registered manager worked closely with the G.P practice and other health services including the local hospice, to improve experiences and outcomes for people, and ensure they received timely access to external healthcare.

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.

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

Rating at last inspection

The service was registered with us on 9 November 2020 and this is the first inspection. The last rating for the service under the previous provider was requires improvement, published on 26 July 2019.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.