Coates Garden House

Coates Garden House is a residential care home. It is set out over 2 floors and has 8 bedrooms. The service is registered to provide support to adults who may be living with a learning disability or autism. At the time of our inspection there were 8 people using the service.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

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. People were supported by staff to pursue their interests and were supported to achieve their aspirations and goals. People had a choice about their living environment and were able to personalise their rooms. The environment was well furnished and maintained and met people’s sensory and physical needs.

Right Care:

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. Staff had training on how to recognise and report abuse and understood how to protect people from poor care and abuse. There was enough appropriately skilled staff to meet people’s needs and keep them safe. Staff and people co-operated to assess risks people might face and where appropriate, staff encouraged and enabled people to take positive risks.

Right Culture:

We have made a recommendation; the provider reviews the governance systems in place at service level. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. Staff turnover was low, which supported people to receive consistent care from staff who knew them well. People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff.

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

Rating at last inspection

The last rating for this service was good (published 26 July 2017)

Why we inspected

This inspection was prompted by a review of the information we held about this service and due to the length of time the service was last inspected.

You can read the report from the last comprehensive inspection, by selecting the ‘all reports’ link for Coates Garden House on our website at www.cqc.org.uk

Follow up

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

Coates Garden House is situated in Patrington, near Withernsea, in the East Riding of Yorkshire. It is set out over two floors and has eight single bedrooms. There are shared bathroom facilities and various communal areas for people to use. The service provides support for up to eight people with learning disabilities and mental health conditions. It is within walking distance of local amenities. At the time of our inspection there were seven people living at the service.

During our previous inspection on 15 April 2015, we found the provider had failed to implement and record robust pre-employment checks to ensure care workers were of a suitable character to work with vulnerable people before commencing their role.

At this inspection we saw recruitment processes ensured people were not exposed to care workers who had been barred from working with vulnerable adults this helped to ensure that only care workers deemed suitable were employed. These checks had been completed before care workers commenced their role.

We were supported during our inspection by a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. The registered manager will be referred to as 'manager' throughout the report.

People told us they felt safe living at the home with the care workers who supported them. Care workers had received training in safeguarding adults from abuse and harm. Systems and processes were in place to ensure any concerns were reviewed and escalated for further investigation and actions were implemented to mitigate re-occurrence and to help keep people safe from avoidable harm and abuse.

The provider had completed risks assessments for the home and for people who lived there. Care and support was provided based on the assessed risks which meant people could live their lives safely without undue restrictions.

People received their medicines as prescribed and safe systems were in place to manage people's medicines. Care workers were trained in medicine administration and their competency was checked. Audits had been introduced for the management and administration of medicines to ensure people received their medicines in line with their prescription and to ensure they were managed according to best practice guidance.

There were enough care workers to meet people's needs. People received support from care workers who respected people’s dignity and privacy and promoted their independence, following their wishes and preferences.

Care plans were managed electronically and information was person centred. People had been involved in their care planning and reviews. Provision had been added to the electronic records for people to sign their consent and agreement to the information held and the provider told us they would be updating this as part of people’s review of their care and support.

People were supported to pursue a wide and diverse variety of social activities relevant to their needs, wishes, culture and interests. Arrangements were in place for people to maintain links with the local community, friends and family.

The manager and care workers had an understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). At the time of our inspection no one living at the service had been assessed for a DoLS. Care and support promoted people’s independence and this was recorded in people’s care plans.

The provider supported care workers with training and supervision to ensure they had the up to date skills and knowledge to carry out their role and meet people’s individual needs.

People chose and assisted in the preparation of their food and drink and were supported to maintain a balanced diet, where this was required. People had access to healthcare facilities and support that met their needs.

Residents meetings were held where people could discuss and contribute to the running of their home and provide feedback on the service they received.

The provider had systems and processes in place to receive and manage any complaints, incidents or accidents. Evaluations of this information included any actions implemented as a result.

The provider completed a range of quality assurance checks around the home. These checks helped to maintain and improve standards of service.

Everybody spoke positively about the way the service was managed. Care workers understood their levels of responsibility and knew when to escalate concerns. The manager had a clear understanding of their role and responsibilities and requirements in regards to their registration with the Care Quality Commission (CQC).

People told us they were very happy living in Coates Garden House. One person told us 'The home is very fantastic'. Another person told us 'I like living here, it's nice'.

We observed positive and supportive interactions between staff and people who used the service. Care plans were being updated and were detailed and personalised.

We looked at the environment which was clean, tidy, well maintained and fit for purpose. Staffing levels were closely monitored and were adapted according to the needs of the people using the service. Staff were fully consulted before any changes were made to staffing arrangements.

We found that there were systems in place for monitoring the quality of the service provided and policies and procedures were in the process of being fully reviewed, with most having been updated since our last visit. We found records to be fully completed, accurate, appropriately stored and that they were audited on a regular basis.

We found that people were able to access the appropriate level of support from staff and had a large amount of independence and autonomy which was balanced with support where it was needed. Care plans and risk assessments were regularly updated and reviewed. People were happy living in the home. One person told us 'I like living here. I have my independence and support when I need it'.

When looking at the management of medication we saw records that were accurate and up to date. Systems of recording and managing medication were robust.

We looked at the support and development of staff and found this to be appropriate and well managed. Staff felt well supported and were trained appropriately.

When we looked at the quality assurance systems within the home we found that these were in need of refreshing and updating. The home was not effectively gathering input from people or staff about the care and support delivered.