We inspected the service on 3 July 2018. The inspection was unannounced. The Coach House provides accommodation and personal care for up to nine people with physical and learning disabilities. The service supports people to be more independent by allowing them to make their own choices and learning new skills. The Coach House is part of The Lifestyles Academy for Independence, which includes day provision and outreach services, within the Strode Park Foundation which is an independent voluntary organisation and registered charity. At the time of the inspection there were eight people living at the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection we rated the service ‘Good’. At this inspection we found the evidence continued to support the rating of ‘Good’ and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

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.

The provider took appropriate action to manage accidents and safeguarding incidents. Staff told us they would report any suspected abuse and knew about the procedure for this. Staff were recruited safely and medicines were stored and administered in a timely manner.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People's needs were assessed before moving to the service and staff had the right skills and training to support people. People were encouraged to eat healthy and balanced diets.

People received a service which was caring. People were treated with dignity and respect by staff who were compassionate and caring. Staff treated people's private information confidentially. People were able to make decisions about how their care was provided, and were involved in reviews along with family members and the appropriate professionals involved with their care.

People received care that was personalised to their individual preferences. Staff knew people's needs and personalities well. When people or their families had complaints or concerns they were encouraged to raise them. Management saw complaints to be an opportunity to improve the service.

There were clear values throughout the service and we saw evidence that that these values were embedded from the provider right through to staff that care for people at The Coach House.

Further information is in the detailed findings below.

We spoke with some of the people who used the service, the registered manager and staff. We also observed staff supporting people with their daily activities.

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?

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people who used the service, the staff supporting them and looking at records.

Is the service safe?

The service was safe. Practices in the service generally protected people using the service, staff and visitors from the risk of harm.

Systems were in place to make sure that managers and staff learned from accidents and incidents, concerns, complaints, whistleblowing and investigations. This reduced the risks to people and helped the service continually improve.

People were cared for in a clean, hygienic environment. Equipment at the home had been maintained and serviced regularly. We found that people using the service were protected from infection because the provider maintained appropriate standards of cleanliness and hygiene.

Each person had a care plan detailing their support and care needs. We saw that there was guidance for staff to follow to reduce risks and implements strategies to make sure people were as safe as possible.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLs) which applies to care homes. One DoLs application had recently been submitted and we found that policies and procedures were in place for completing this. Relevant staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

The service was effective. People told us that they were happy with the care that had been delivered and that their care needs were met. One person we spoke with told us, “I like it here”. We saw that staff were attentive to people using the service and responded promptly when needed.

Staff support was consistent and structured. People who were unable to communicate verbally used other methods, for example, a computerised communication system.

People’s health and care needs were assessed with them and /or their representatives. We found that care plans were regularly reviewed to reflect any changes in a person’s needs.

Is the service caring?

The service was caring. People were supported by kind and attentive staff. We saw that staff showed patience and gave encouragement when supporting people. People we spoke with said they felt staff respected their privacy and dignity and staff were polite and caring.

Is the service responsive?

The service was responsive. People told us that they were happy with the service. It was clear from observations and from speaking with staff that they had a good understanding of the people's care and support needs.

We found that people were supported to attend health appointments, such as, doctors or dentists. We saw records to show that the service worked closely with health and social care professionals to maintain and improve people's health and well-being.

Is the service well-led?

The service was well led. There was a clear management structure in place quality assurance processes were in place. Staff told us they were clear about their roles and responsibilities and that they felt supported by the management team. Systems were in place to ask people who used the service, relatives and staff for their views about the service. Audits of the care plans had been completed to assess the quality of the care being provided.

We made an unannounced visit to the service and spoke people using the service, the registered manager and staff members. There were nine people using the service at the time of our visit.

We used a number of different methods to help us understand the experiences of people using the service. This was because some of the people had complex needs which meant they were not all able to tell us their experiences.

We observed the interactions between people and staff. We observed how people reacted and responded to see if people indicated they were happy, bored, discontented, angry or sad.

We saw that people were asked for their consent to treatment and the provider acted in accordance with their wishes.

People who use the service indicated that they were happy at the home. They were relaxed and responsive in the company of staff. Staff engaged with people in a warm and positive way and supported people where needed. Records showed that people had the care and support they needed to remain well and healthy.

We saw that the provider had measures in place to help safeguard people from abuse. We saw that there were measures to check that people were reliably provided with the facilities and services they needed.

People who use the service had their medicines at the times they needed them and in a safe way.

We saw that there were enough qualified, skilled and experienced staff to meet people’s needs.

We made an unannounced visit to the service and spoke to the people who use the service, the Registered Manager and to staff members. There were nine people using the service at the time of our visit. We spoke to all of the people who were at home and everyone we spoke to said or expressed that they were happy living at The Coach House. We observed interactions between the people and the staff and peoples responses to the staff. We observed to see if people were happy, bored, discontented or sad.

People told us or expressed that they were well looked after, felt safe and would talk to staff if they had a problem. We were told “the staff are nice and they look after me”.

People told us or expressed that there were plenty of activities going on and how they enjoyed them. On the day prior to our visit some of the people who use the service had been on a seven mile sponsored walk which they did in stages depending on their individual abilities. People told us they enjoyed this.

Staff interacted and engaged with people in a warm and positive way. We were told “I like it here and wouldn’t change anything. I like things just how they are”.

The staff we spoke to understood each person’s individual needs and how they liked to be supported.

This inspection took place on 15 and 16 October 2015 and was unannounced.

The Coach House is part of the wider provision of The Lifestyles Academy for Independence, which includes day provision and outreach services, within the Strode Park Foundation which is an independent voluntary organisation and registered charity. The service is a nine bedded home which supports young adults with physical and learning disabilities to make choices, take risks and supports people to achieve independence skills. At the time of the inspection there were nine people living at the service.

A registered manager was 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 told us and indicated by using a thumbs-up sign that they felt safe living at the service. People looked comfortable with other people, staff and in the environment. Staff understood the importance of keeping people safe. Staff knew how to protect people from the risk of abuse.

Risks to people’s safety were identified, assessed and managed appropriately. People received their medicines safely and were protected against the risks associated with the unsafe use and management of medicines.

Accidents and incidents were recorded and analysed to reduce the risks of further events. These were used as a learning opportunity and shared with other services run by the provider.

Recruitment processes were in place to check that staff were of good character. There was a training programme in place to make sure staff had the skills and knowledge to carry out their roles effectively. People were supported by sufficient numbers of staff.

People were provided with a choice of healthy food and drinks which ensured that their nutritional needs were met. People’s health was monitored and people were supported to see healthcare professionals when they needed to. People’s weights were not consistently monitored and recorded.

The registered manager and staff understood how the Mental Capacity Act (MCA) 2005 was applied to ensure decisions made for people without capacity were only made in their best interests. However, we have made a recommendation regarding consent.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been agreed by the local authority as being required to protect the person from harm. DoLS applications had been made to the relevant supervisory body in line with guidance.

People and their relatives were involved with the planning of their care. People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. Staff were kind, caring and compassionate and knew people well. People were encouraged and supported to increase their independence by setting their own goals.

People were supported by staff to keep occupied and there was a range of meaningful social and educational activities available, on a one to one and a group basis, to reduce the risk of social isolation.

People, their relatives and staff were encouraged to provide feedback to the provider to continuously improve the quality of the service delivered.

The registered manager coached and mentored staff through regular one to one supervision. The registered manager worked with the staff each day to maintain oversight of the service. Staff said that the service was well led, had an open culture and that they felt supported in their roles. Staff were clear what was expected of them and their roles and responsibilities.

Services that provide health and social care to people are required to inform CQC of important events that happen in the service. CQC check that appropriate action had been taken. The registered manager had submitted notifications to CQC in an appropriate and timely manner in line with CQC guidelines.