The inspection took place on 11December 2017 and was unannounced. A second day of inspection took place on 14 December 2017 which was announced.

The Coach House Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The Coach House Nursing Home is registered to provide accommodation for persons who require nursing and/or personal care for up to 42 people. This may also include palliative and respite care. There were 40 people living at the service on the day we inspected.

The care home is a large detached property situated in its own grounds. Accommodation is provided over three floors and there are two passenger lifts for people who have reduced mobility.

At the last inspection, the service was rated good. At this inspection we found the service remained good.

There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about different types of abuse and were aware of action they should take if abuse was suspected.

Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety.

People were protected by a robust recruitment process, which ensured staff were suitable to work with people who needed support.

People received their prescribed medicines safely. Medicines were administered by staff who were trained and assessed as being competent to do this.

Staffing levels were sufficient to meet people's needs and to enable them to do be supported in a way that they wished. Staff received support and training to give them the necessary skills and knowledge to meet people's assessed needs.

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.

Risks to people's safety had been assessed by staff and regularly reviewed to ensure they contained up to date information. Care plans included information about how people preferred to be supported.

People's independence was encouraged and there were a range of activities and events people could participate in.

We saw positive interactions between people and staff and people told us they were happy and felt well cared for. Staff treated people with dignity and respect. They knew people well and respected their individuality.

We saw people were provided with a choice of healthy food and drinks which helped to ensure their nutritional needs were met. People were supported to maintain good health and had access to healthcare professionals and services.

The provider had a system in place for responding to people's concerns and complaints. People were regularly asked for their views and there were effective systems in place to monitor and improve the quality of the service provided.

Further information is in the detailed findings below.

The inspection took place on 11December 2017 and was unannounced. A second day of inspection took place on 14 December 2017 which was announced.

The Coach House Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The Coach House Nursing Home is registered to provide accommodation for persons who require nursing and/or personal care for up to 42 people. This may also include palliative and respite care. There were 40 people living at the service on the day we inspected.

The care home is a large detached property situated in its own grounds. Accommodation is provided over three floors and there are two passenger lifts for people who have reduced mobility.

At the last inspection, the service was rated good. At this inspection we found the service remained good.

There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about different types of abuse and were aware of action they should take if abuse was suspected.

Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety.

People were protected by a robust recruitment process, which ensured staff were suitable to work with people who needed support.

People received their prescribed medicines safely. Medicines were administered by staff who were trained and assessed as being competent to do this.

Staffing levels were sufficient to meet people's needs and to enable them to do be supported in a way that they wished. Staff received support and training to give them the necessary skills and knowledge to meet people's assessed needs.

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.

Risks to people's safety had been assessed by staff and regularly reviewed to ensure they contained up to date information. Care plans included information about how people preferred to be supported.

People's independence was encouraged and there were a range of activities and events people could participate in.

We saw positive interactions between people and staff and people told us they were happy and felt well cared for. Staff treated people with dignity and respect. They knew people well and respected their individuality.

We saw people were provided with a choice of healthy food and drinks which helped to ensure their nutritional needs were met. People were supported to maintain good health and had access to healthcare professionals and services.

The provider had a system in place for responding to people's concerns and complaints. People were regularly asked for their views and there were effective systems in place to monitor and improve the quality of the service provided.

Further information is in the detailed findings below.

We spoke with four visitors, seven people who used the service and some of the staff on duty. Several people who lived at the home were able to tell us about their experience. Everyone told us they were satisfied with the care they or their relative received. People told us that they were treated with respect and were able to make choices and decisions about their care.

We saw from people's care plans that people were supported to live as independently as possible. Staff at the home had carried out an assessment of the needs of each person, and kept this under review, to enable appropriate care and support to be given.

The service had in place policies and procedures covering medication. People told us they received their medication at the right time. Staff working at the home received regular medication training. This made sure that people received their medication as prescribed.

There were enough staff on duty to meet people’s needs. Staff were receiving training on a regular basis and this was monitored by the manager.

There were quality monitoring programmes in place, which included people giving feedback about their care and treatment. This provided a good overview of the quality of the service provided and meant the quality of the service was being kept under review.

We used a number of different methods to help us understand the experiences of people using the service,however we did speak with five people when we visited the home. People we spoke with told us about the care they received and what it was like living at the home. People told us that they were well looked after and that they were happy with the care they received. Comments made to us included “They look after me well” and “some of the staff here are saints.”

We spoke with people about meals at the home. They told us that the food was good.

Everyone we spoke with said that if they were upset or had a complaint they would either speak to the manager of the home or the administrator. One person said “I would speak to matron and she would sort it out.”

We spoke to two relatives visiting the home. They both spoke highly about the care at The Coach House. Relatives described the home as being ‘a lovely home’ with ‘good staff’. Relatives made comments such as “They look after (name of person) very well.”

We also spoke with health care professionals about the home. One told us “The Coach House is quite a nice home. They (staff) keep tabs on all of their patients. Staff are always helpful when we visit.”

We spoke with the Local Authority Contracts Officer and the Infection control nurse who informed us that they did not have any concerns about this service.

People told us that they were well looked after and that they were happy with the care they received. People made comments such as "I am quite happy living here and feel quite safe" and "We are looked after well here"

People we spoke with also made positive comments about the quality of the food at the home. People made comments such as "The food is excellent you always have a choice" and "The food is quite good - a good variety" One person told us " It is beautiful here I can't complain about anything especially the food"

People said they would either speak to the manager or administrator if they did have a concern or a complaint.

We also talked with several relatives visiting the home. They all spoke highly about the care at The Coach House. Relatives described the care as 'excellent' and 'a very nice home' Relatives made comments such as "Mum's health has improved so much in the time she has been here. They treat her with dignity and respect" Another relative told us "People always seem to be so happy" and another said "Staff are so approachable"

We also spoke with health care professionals who spoke highly about the home. One told us "The Coach House is an absolutely exceptional home - exemplary. I cannot fault it. Patients and relatives tell me that the care is extremely good and I always get a positive feedback from them" Another health care professional said "There are lovely, friendly staff here who will do anything for the residents"

We spoke with the Local Authority Contracts Officer who informed us that they did not have any concerns about this service.