This inspection took place on 14 November 2018 and was unannounced. Townfield and Coach House is a residential care home that provides accommodation 28 older people, who are living with dementia. At the time of this inspection 25 people were living in the home. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At our last inspection in June 2016 the service was rated 'Good'. At the present inspection the service remained 'Good'. At this inspection we found the evidence continued to support the overall 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.

The home 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.

People remained safe at the home. People were protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse. Staff had been trained in how to follow these procedures. Risk assessments were conducted and risk management plans were in place which enabled people to receive care with minimum risk to themselves and others.

The registered manager monitored accidents and falls in order that preventative measures were put in place to avoid reoccurrence and promote the safety of people who use the service, the staff and anyone visiting the home.

Staff had been supported to deliver care in line with current best practice guidance. People were able to eat and drink enough to maintain a healthy weight whist being provided with a balanced diet. People had access to healthcare services so that they received on-going healthcare support.

People were protected from the risk and spread of infection because staff consistently followed the provider's infection control procedures. The home was clean and free of unpleasant odours.

Equipment used to support people was clean, in a good state of repair and was regularly serviced.

Staff had been safely recruited and there were sufficient numbers of staff on duty to meet people's needs in a way which met their preferences and promoted their independence. People told us they felt safe in Townfield and Coach House. Staff had received training in the protection of adults and knew what action they should take if they suspected or witnessed abuse.

Staff knew people well and understood how to meet their needs. People's rights were protected. The registered manager and staff had a good understanding of the Mental Capacity Act 2005 and acted according to this legislation. People and their relatives where possible had been consulted about their care and support needs which were assessed before they moved into the home. Care plans and risk assessments included information and guidance for staff about people's needs and how they preferred their needs to be met.

People were enabled to maintain relationships with their family and friends; visitors were made to feel welcome. People were encouraged to participate in organised activities and to go out on trips.

People's medicines were safely managed. We observed that people received their medicines wherever they felt most comfortable.

People's records were kept safely to maintain confidentiality.

The layout and decoration of the home met people's needs. The environment was adapted in order that people could freely move around without restriction or risk to their safety. A great deal of thought

We carried out an inspection of Townfield and Coach House on 1 and 2 June 2016. The first day was unannounced.

Townfield and Coach House is registered to provide accommodation and personal care for up to 28 people. At the time of the inspection there were 23 people living in the home. The service specialises in providing care for people living with dementia. People required a range of help and support in relation to their dementia and care needs. The home is located close to Great Harwood town centre and all local amenities. Accommodation is provided on two floors linked by a passenger lift, stair lifts and stairs. Communal space is available on the ground and first floor.

The service was managed by a registered manager. 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.

At the last inspection on 6 December 2013, we found the service was meeting the regulations which were applicable at the time. During this inspection we found the service was meeting the current regulations. However, we made a recommendation about further developing the environment to help people living with dementia to find their way around the home.

People living in the home said they felt safe and staff treated them well. Care delivery was supported by clear up to date care documentation which was personalised and regularly reviewed. Staff felt that training provided was effective and ensured they were able to provide the best care for people. Care plans and risk assessments had been completed to ensure people received appropriate care. These had been written using information sought from the person or their relatives if appropriate. This meant plans and assessments were person centred and reflected people's personal choices and preferences.

Medicine documentation and relevant policies were in place. These followed best practice guidelines to ensure people received their medicines safely. Regular auditing, checks and staff competencies were carried out to ensure high standards were maintained.

Staff received training which equipped them for their roles and supported them in providing safe care for people. Robust recruitment checks were completed before staff began work. Staff demonstrated a clear understanding on how to recognise and report abuse and treated people with respect and dignity.

People's mental health and capacity were assessed and reviewed with pertinent information in care files to inform staff of people's individual needs. People were encouraged to remain as independent as possible and were supported to participate in daily activities. People were given choices and involved in day to day decisions about how they spent their time. People were asked for their consent before care was provided and had their privacy and dignity respected. People's nutritional needs were monitored and reviewed. People were given a choice of meals and staff knew people's likes and dislikes. Healthcare referrals were made appropriately to outside agencies when required.

The registered manager took into account the views of people and their relatives about the quality of care provided through daily conversations, meetings and satisfaction surveys. The registered manager used the feedback to make improvements. Notifications had been completed to inform CQC and other outside organisations when events occurred.

People using the service told us they liked living at Townfield Coach House and received the care and support they needed. One person said, “Everything’s nice in here.” Another person said, “We get spoilt never mind looked after.”

All the people we asked said they enjoyed the meals. One person said, “The food is lovely, she can cook as good as my mum.” People's weight was monitored and when necessary advice was sought from other healthcare professionals.

We found that the home was clean, warm and well maintained. People were encouraged to make their own rooms more homely with personal items such as photographs, ornaments and pictures for the wall.

We noted that recruitment procedures were thorough in order to protect people from the employment of unsuitable staff.

We noted that systems were in place to monitor the quality of the service provided. There was evidence to demonstrate that people were regularly consulted about the care and facilities provided at the home.

People using the service told us they liked living at Townfield Coach House and were satisfied with the care provided. They explained that members of staff always asked permission before providing any care or support. One person said, “They listen to you and help you.”

We found that suitable arrangements were in place for the safe keeping and handling of medicines.

People using the service said there was enough staff on duty to meet their needs. We saw that staff responded promptly when people asked for assistance.

We saw that appropriate and accurate records were kept for people using the service and the overall effective management of the home.

People using the service told us they liked living at Townfield and Coach House and were satisfied with the care provided. They said the home was clean and comfortable and the meals were good and they were given a choice of menu for each meal.

People were treated with dignity and respect. One person said, “They look after us, you get what you want.” Another person said she could have a cup of tea when she wanted.

People were encouraged to make choices about their daily routine. They told us they could choose when to get up and go to bed.

Visitors were welcomed into the home at any time and offered refreshments.

Leisure activities were routinely organised at the home. One person said, “They get people in like singers and we really enjoy it.” Another person said, “They try to keep us occupied. If it’s a nice day they take us out for a walk.”