Archived: The Coach House Residential Home

Updated 27 November 2018

The inspection: 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.

Inspection team: Two inspectors visited on both days.

Service and service type: The Coach House Residential Home is a care home. People in care homes receive accommodation and personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means 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 announced. We told the provider we would be visiting on both days.

What we did:

We reviewed information we had received about the service since the last inspection. This included details about incidents the provider must notify us about, such as abuse; and we sought feedback from the local authority, clinical commissioning group (CCG) and other professionals who work with the service. We assessed the 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 used all this information to plan our inspection.

During the inspection we spoke with three people and four relatives to ask about their experience of the care provided. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with six members of staff including the registered manager who is also the owner (provider) and the co-owner. They are referred to as the provider in this report. We spoke with the chef, administrator and two care workers. During and following the inspection we spoke with three visiting professionals.

We reviewed a range of records. This included five people’s care records and multiple medication records. We also looked at two staff files around staff recruitment. Various records in relation to training and supervision of staff, records relating to the management of the home and a variety of policies and procedures developed and implemented by the provider. Some of this information was received following the inspection.

Updated 27 November 2018

What life is like for people using this service:

Since our last inspection the provider had failed to effectively act on the recommendations and breaches identified to make sufficient and sustained improvements. The provider displayed a commitment to providing high quality person centred care but lacked the knowledge in some areas to implement safe systems to achieve this. The provider demonstrated their motivation to improve by working alongside the local authority and ourselves during and after the inspection.

The provider told us they would be seeking up to date policies which they could follow to demonstrate they worked within the law and used best practice to achieve positive outcomes for people in the future. The quality assurance system in place was not robust enough to ensure quality and safety. Formal ways of involving staff, people and their relatives were not in place. Systems to learn from accident and incidents to demonstrate continuous improvement were not in place. Risk assessments based on recognised evidence were not used to prevent people being at risk of avoidable harm. These systems need to work together to improve the safety and quality of the service.

People did not always receive effective care and support based on best practice. Where people’s needs had changed the provider did not always consider their environmental and moving and handling needs.

People told us they felt safe and well cared for. Staff afforded people respect and dignity and delivered care and support with compassion. People enjoyed the opportunities available to participate in activities. They told us overall, they would like to see more activities and time to access the community.

More information is in detailed findings below. We identified two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 around governance and the environment. Details of action we have asked the provider to take can be found at the end of this report.

Rating at last inspection: Requires Improvement (report published 21 March 2017)

About the service: The Coach House Residential Home is a residential care home for up to 15 older people, some of whom may be living with dementia. At the time of the inspection 11 people lived in the service.

Why we inspected: This was a planned inspection based on the rating at the last inspection. Sufficient improvements had not been made since our last inspection which means the rating remains at requires improvement. This is the second consecutive time this service has been rated requires improvement.

Follow up: We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress.