What life is like for people using this service:

The property was clean, comfortable, with plenty of room for people to live. Everyone had their own room with en-suite facilities.

People told us they felt safe and happy and the service was their home.

There were safeguarding systems and processes in places that sought to protect people from harm. Staff knew the signs of abuse and what to do if they suspected it. There were sufficient staff in place, all of whom had passed safe recruitment procedures to ensure they were suitable for the role. There were systems in place to monitor people's safety and promote their health and wellbeing, these included risk assessments, risk management analysis tools and care plans. The provider ensured that when things went wrong, incidents and accidents were recorded and lesson were learned.

People needs were assessed in detail before moving to the home so the provider knew whether they could meet the person's needs. Staff were sufficiently skilled and experienced to fulfil their roles, received training and were supported through regular supervision. People were prompted to eat and drink healthily and could choose what foods they wanted to eat. People were supported to have choice in their daily lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were treated kindly and compassionately by staff. People and their relatives were supported to express their views and make decisions about the care and treatment they received. Staff respected people's privacy and dignity.

People received personalised care, having their support needs and preferences detailed in their care plans. People were supported to lead fulfilled lives through activities of their choice. The provider had a complaints policy and process in place; people and their relatives told us they would feel comfortable raising complaints. When people were at the end of their life, the provider worked with them to meet their wishes and preferences and to live pain free.

People and staff thought highly of the registered manager and that the service was well managed. Staff knew their roles and understood what was expected of them. The registered manager knew their responsibilities in ensuring people received a safe, high quality service. People and staff were engaged in the service and their opinions were sought. There were quality assurance systems in place to assist the provider to monitor and improve its care and treatment of people. The service had built local community links to benefit the lives of people using the service.

At this inspection we found the evidence supported a rating of ‘Good’ in all areas, and continues to support a rating of ‘Good’ overall. More information in 'Detailed Findings' below.

Rating at last inspection: At our last inspection in March 2016 we rated the service as ‘Good’ overall, we rated Safe as ‘Required Improvement’.

About the service: Coton Grange is a residential care home that provides personal care for up to 29 people. At the time of the inspection 26 people lived at the home.

Why we inspected: This was a planned comprehensive inspection that was scheduled to take place in line with Care Quality Commission scheduling guidelines for adult social care services.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

This inspection was unannounced and took place on 14 March 2016. At the last inspection in July 2013, we found the provider was meeting all of the requirements of the regulations we reviewed.

Coton Grange is registered to provide accommodation for up to 26 people who require personal care and support. On the day of the inspection there were 26 people living at the home. There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 did not always receive their medicines as prescribed and staff were not always clear about when people should be offered their ‘as and when required’ medicines. People told us they felt safe. Risks to people’s health and safety had been assessed and were managed. There were sufficient staff to support and respond to people and the provider carried out appropriate recruitment checks to reduce the risk of employing unsuitable staff.

People and relatives expressed confidence in the staff who supported them and staff felt they had received training that gave them the skills they required to meet people’s individual needs. People were asked for their consent before care was provided and staff had assessed people’s capacity to make certain decisions.

People and their relatives liked the staff and felt they were friendly and caring. Staff understood people’s individual needs and spent time with people getting to know them. Staff supported people in a way that protected their dignity and privacy.

People and their relatives were involved in decisions about their care and support. Activities were offered which took account of people’s interests and hobbies. People and their relatives knew how to complain and the provider had a system in place for managing complaints.

People and staff felt the home was well managed. The provider welcomed feedback from people, relatives and staff and held regular meetings to gather people’s views. Staff felt supported by the registered manager and provider and were confident they would be listened to if they raised concerns. The registered manager and provider had a good knowledge of their responsibilities and had notified us of things they were required to do by law.

During this inspection, we spoke with five people, six relatives, five staff members and the home owners, one of whom is the home manager. The management of the home had recently changed, so there were a few changes taking place during our inspection.

People and their relatives were involved in the planning of care. One person said, “The staff always ask me what I want.”

People’s care was planned and delivered appropriately. Records indicated that a proactive approach had been taken to ensure people received care from other professionals in a timely manner. One person told us, “It is marvellous, they are a caring bunch.”

Arrangements were in place to ensure that people were protected from harm. We saw that further considerations had been made to offer people opportunities to improve their safety and security around the home.

We found that there was a sufficient number of staff to ensure that people received appropriate care. One staff member said, “There is enough staff here.” People and their relatives were complimentary about the staff.

We found that robust arrangements were in place to ensure that risks were identified and that improvements were made when shortfalls were found. One relative said, “Things have improved so much since the new management have come in. It is really good now.”