Archived: The Coach House

The Coach House is one of several services owned by Family Mosaic Housing. The service provides accommodation, personal care and nursing care for up to 12 people who have a neurological condition which has been acquired through a life changing event or diagnosis.

The service had a registered manager in post. 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 2008 and associated Regulations about how the service is run.

Staff had a good understanding and knowledge of safeguarding procedures and were clear about the actions they would take to protect the people they supported.

There were sufficient numbers of staff available to meet people’s needs. Appropriate recruitment checks were in place which helped to protect people and ensure staff were suitable to work at the service. Staff told us that they felt well supported in their role and received regular supervision and an annual appraisal of their overall performance.

Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed. Care plans were sufficiently detailed and provided an accurate description of people’s care and support needs. People were supported to maintain good healthcare and had access to a range of healthcare services. The management of medicines within the service was safe.

Appropriate assessments had been carried out where people living at the service were not able to make decisions for themselves and to help ensure their rights were protected.

People were supported to be able to eat and drink satisfactory amounts to meet their nutritional needs and the mealtime experience for people was positive.

People were treated with kindness and respected by staff. Staff understood people’s needs and provided care and support accordingly. Staff had a good relationship with the people they supported.

An effective system was in place to respond to complaints and concerns. The provider’s quality assurance arrangements were appropriate to ensure that where improvements to the quality of the service was identified, these were addressed.

We looked at three people's care records. We also looked at the provider's arrangements for obtaining, and acting in accordance with, the consent to care and treatment for people who used the service. In addition we looked at the provider's arrangements to safeguard people from abuse, the management of medicines within the service, staff training, supervision and appraisal records and the provider's arrangements to monitor the quality of the service provided.

Observation of staff practices throughout the day of our inspection was undertaken to ensure that people who used the service were treated with respect and dignity.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

People told us they felt safe living in the service. They also told us that they would feel able to speak up if they had concerns or worries and felt that they would be listened to.

Records showed that staff had received Mental Capacity Act [MCA] 2005 and Deprivation of Liberty Safeguards [DoLS] training. Staff spoken with were able to demonstrate a good understanding and awareness of MCA and DoLS. We found that people who used the service had had their capacity to make day-to-day decisions formally assessed.

Since our last inspection of the service on 19 December 2013, we found that there had been no safeguarding concerns raised by the Local Authority or by the Care Quality Commission. We saw that the majority of staff had received training in safeguarding of vulnerable adults from abuse. This meant that staff were provided with the information that they needed to ensure that people were safeguarded.

The provider now had suitable arrangements in place in relation to the management of medicines. This meant that people were protected against the risks associated with the unsafe use and management of medicines.

Suitable measures were in place to ensure that staff employed at The Coach House received appropriate training, supervision and appraisal. This meant that people who used the service had their health and welfare needs met by competent staff.

Is the service effective?

Our observations and discussions with the manager demonstrated that people who used the service received regular support and access from a variety of health and social care services and professionals as their conditions and circumstances required.

Records showed that there were appropriate arrangements in place for people who used the service to receive co-ordinated care, treatment and support.

We found that the majority of staff working at the service had received core training for the needs of the people they supported. In addition records showed that staff had received formal supervision and appraisal.

Is the service caring?

People told us that they received the care they needed. People living in the service told us that they were happy living there. Our observations showed that care and support was provided in a timely manner. People's relatives told us that they were happy with the care and support provided for their member of family.

People who used the service had a care plan in place detailing their specific care needs and the support to be provided by staff.

Is the service responsive?

People's preferences and diverse needs had been recorded in accordance with people's wishes.

Our observations during our inspection showed that visiting times were flexible.

We found that there were appropriate arrangements in place pertaining to complaints management.

Is the service well-led?

The provider was able to demonstrate that there were systems in place to assess and monitor the quality of the service provided. The views of the people who used the service and staff had been sought. People's views about the service were noted to be positive.

Where concerns had been highlighted in relation to the previous management arrangements at The Coach House, the provider had taken proactive action to address these. At the time of our inspection an acting manager was in post to ensure that the service was well run.

Our observations suggested in general that people living at the service were happy, that they felt safe and were well cared for. It was evident that people who used the service had a good relationship and rapport with the staff who supported them.

Each person's health and personal care needs were assessed and there were detailed care plans in place for care staff to follow so as to ensure that people were supported safely and in accordance with their individual preferences and wishes. Staff spoken with demonstrated a good understanding of people's health and personal care needs and how each person wished to be supported. However improvements were required to ensure that routines within the service were person led rather than routine based. We also found that there was a lack of social activities available.

The service was kept clean and provided a hygienic and pleasant place for people to live.

Improvements were required in relation to medicines management at the service and this remains outstanding from our last inspection in 2012.

The provider had appropriate arrangements in place to ensure that staff were appropriately trained to meet people's needs. Records showed that staff were regularly supervised and appraised.

Improvements were required in relation to the service's medication practices and procedures. We also found that improvements were required in relation to ensuring that people's records were reviewed, updated and accurate.