The Coach House SBDP1 Limited

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Requires Improvement. At this assessment the rating has changed to Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

The service was previously in breach of the legal regulation in relation to the need for consent. Improvements were found at this assessment, and the service was no longer in breach of this regulation.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs, risks and choices were assessed and planned for. People and their representatives told us they were involved in their needs assessments and with compiling their care plans. A person’s representative told us, “I have seen the care plan and was involved in drawing it up. They do consult me if they want to change anything.”

People’s care plans contained clear and detailed information, with appropriate use of language, regarding their care needs and the levels of support they required. Care plans also contained information about people’s individual choices and preferences.

Staff told us that everybody had a full review of their care and support on a regular basis. A member of staff told us, “Residents have detailed care plans and risk assessments, which provide guidance on their individual needs and how they should be supported. I feel very confident in providing person-centred support and meeting individual care needs.”

Another member of staff explained, “As a professional healthcare assistant in The Coach House, I regularly care for and support the same people over weeks, and months. Before starting my daily work, I make sure I read the personal assessment of each resident I have been assigned to assist, to know their unique physical, emotional, and social requirements of the day.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff assessed and planned for people’s nutrition and hydration needs, including dietary and cultural preferences.

Some people were at risk of choking and had been assessed by a speech and language therapist (SALT). Staff followed the SALT advice and guidance to make sure people ate and drank safely. Some people were deemed as being underweight and we saw these people were supported to have fortified meals and drinks.

Staff completed electronic records of people’s daily wellbeing, including what they had consumed during the day. The electronic system appeared to be mostly effective and provided detailed records. However, it was not always clear how some people’s fluid intake and target amounts were being set and monitored, or how any concerns were flagged up. We discussed this with the management team and we were assured that there was effective monitoring, by way of additional observations and manual record keeping, as well as daily staff handovers.

Staff were responsive and attentive with people and supported them to follow their eating and drinking care plans. People and their representatives were complimentary about the food.

A member of staff told us, “I have a good understanding of residents' dietary requirements. Mealtimes are one of the positive aspects of my experience at the care home. The food is well prepared and takes individual choices and dietary needs into consideration. Both residents and staff enjoy the mealtime experience.”

A person’s representative told us, “[Relative] always says that the food is delicious.”

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

There was a collaborative approach in supporting people’s care needs. Staff communicated effectively with other professionals. Referrals to external health and social care professionals were made promptly when needed and care records, as well as observations, confirmed that guidance and recommendations were followed.

All staff we spoke with were open and willing to engage. Staff were knowledgeable about the needs of people living in the home and respectful when discussing people’s care needs.

A healthcare professional told us, “I have always found the staff friendly, approachable and knowledgeable of a resident's care and support needs, and it has never felt like a 'bother' to visit. I feel that the staff are extremely lucky to have [Registered Manager] not only as their manager, but also so present to support any concerns raised or acknowledge learning opportunities. I have no doubt that [Registered Manager] goes above and beyond in being available for both residents and staff whenever necessary.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People told us they were able to see doctors and other professionals when needed. They were happy with the support they had.

People’s representatives told us that staff in the home were very good at recognising and addressing changes in people’s needs, following professional and clinical guidance and taking appropriate action.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff regularly monitored people’s wellbeing and support. When people were unwell, or there was a change in their conditions, management and staff increased monitoring to make sure they received medical support if needed.

Staff told us that monitoring people’s wellbeing was a continual process because there were frequent interactions with each individual.

A person’s representative told us, “I would not choose to have [Relative] in any other home. I visit [Relative] every day to help with lunch, so have many hours of observing how the home runs and, more importantly, how the staff care for the residents. I have never seen anything that worried me regarding how [Relative] would be treated in my absence. I have no compunction talking to [Registered Manager] about any concerns I have, big or small. [Registered Manager] reassures or reacts immediately and I’m very satisfied with my relationship with all senior staff.”

This representative explained how the local doctor had prescribed a medicine that their relative had taken before, but a side effect had been “aggressive” behaviour. They told us how they had spoken about their concerns to the registered manager, who arranged for a meeting at the home with the representative and the local GPs. The representative went on to say, “They listened and agreed [Relative] would have a 2-3 week period without the medication, on the understanding that any changes in [their] health would mean the medication would be reintroduced. This was many weeks ago and all has been well.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People, or their legal representatives, were asked to consent to their care and treatment. Managers assessed people’s mental capacity to make different decisions. When people lacked capacity in any particular area, management and staff liaised with their families and other professionals to help make decisions in their best interests. People were also supported to access independent advocates when needed.

People and their representatives told us people were given choices and consented to their care. A person’s representative told us, “Carers explain what they are going to do and ask for permission before they do it.”

A healthcare professional told us, “[Residents] have always reported that they feel safe, content and happy… I have visited residents and have found the staff supporting them to be knowledgeable, not only of the mental and physical health conditions of residents, but also their personal traits, behaviours and likes and dislikes.”