Archived: Coach House Nursing Home

Coach House Nursing Home is registered to provide accommodation, nursing and personal care for adults who have a dementia related illness for a maximum of 17 people. There were 15 people living at home on the day of the inspection.

There was a registered manager in place. However whilst they were not actively involved in the day to day running of the home there was a day to day manager in post. The manager was supported by one of the owners of the home. A 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 2008 and associated Regulations about how the service is run.

People told us they felt safe and staff were available to support them. People were helped by staff to reduce the potential risk of harm and abuse. Medicines were given to people as prescribed or as they needed them. People felt they had staff that were always around and they did not have to wait for assistance. Staff at the home agreed they were able to look after people and meet their needs, without delay.

Assessments of people’s capacity to consent and records of decisions had not been completed. The provider could not show where people had not been able to give their consent to care and treatment or that the relevant people had been consulted. People told us they liked the staff and felt they knew how to look after them. Staff also ensured they listened and responded to people’s day to day choices about their care and support.

Staff were provided with training that they told us helped them understand and know how to provide care in areas like dementia care. Staff were supported by the manager and provider and told us they were able to speak to them for advice and guidance when needed.

People enjoyed the choice of meals and had been supported where further assistance or particular diets were needed. People had accessed other health and social care professionals when needed to support their health. People were helped to contact and arrange appointments with services which were not available within the home. They had regular visits from one local GP surgery when needed.

Staff knew the care needs of people who felt involved in their care and treatment. Staff were clear about the levels and expected care needs of people at the home. People’s privacy and dignity were respected and staff were kind to them. People had been involved in the planning of their care and relatives were involved in supporting their family members care.

People were able to spend time doing the things they enjoyed and in an environment they liked. People and relatives both felt that staff were approachable and listened to their requests. Staff also felt confident to raise any concerns of behalf of people.

The management team were approachable and visible within the home and people knew them well. The manager spent time with people and staff and people were positive about them. The provider had kept their knowledge current and they led by example. The provider and manager had made regular checks to monitor the quality of the care that people received and look at where improvements may be needed.

During this inspection we found that progress had been made.

We spent time watching to see how staff supported people, and talking with people about life at the home. We spoke with five people who lived at the home and one relative. We also looked at records, and spoke with three staff and one of the providers.

People who lived at the home that we were able to speak with were happy with the quality of the care provided. They said, 'I am quite happy here and staff help me when I need them to' and 'It's excellent here and they (staff) all care.' Another person told us that the home was: 'Spotlessly clean and homely'.

Throughout the day we saw staff supported people with words of encouragement where needed when completing tasks. We saw that staff had a good rapport with people and it became evident that the provider and staff knew people's likes and dislikes. This enabled staff to offer effective care and support to people.

We found that there were systems in place for monitoring the quality of the service. We saw that any improvements required were introduced so that people received effective care and treatment.

We looked at a selection of care plans for four people who lived at the home. These care plans had been improved following our last inspection as they identified each persons needs. This was positive as staff had the information required to meet each person's needs so that people were not at risk of receiving inappropriate care.

We looked at the medicines for three people who lived at the home and found that improvements had been made following our last inspection. People had received their medicines as prescribed by their doctors to meet their health needs.

Two people who lived at the home told us they were happy with the care and support they received. One person told us that staff were kind and helpful.

The representative of one person who lived at the home told us, 'Could not find a better home for him' and staff, 'Are very caring.'

Staff had received the training they needed to be able to safely support the people living there.

There were no regular arrangements in place for monitoring the quality of the service and for people who lived at the home to provide feedback and make suggestions for improvement.

Due to people's condition we were unable to speak with the majority of people who were using the service. We spoke with two people who told us that they, 'Couldn't have a better place to live' and 'It's the next best thing to home.'

We found that suitable arrangements were not in place to ensure that care plans were always in place detailing people's care needs. Staff were not always fully aware of people's care needs. This meant that there was a risk of people not receiving appropriate care.

Information on safeguarding vulnerable adults was available. We found that the staff were aware of their responsibilities regarding the reporting of abuse.

We found that improvements had taken place in the management of medication. Further improvements were needed to ensure that people are not at risk of medication errors or not receiving their medication as prescribed.

Systems were not fully in place to make sure that staff received suitable training and support for them to deliver care and treatment to people who used the service.

Systems were not in place to adequately identify, assess and monitor the quality of care provided and as a means to identify any improvements needed. This placed people at risk of receiving inappropriate care and support.