The inspection took place on 12 July 2017 and was unannounced.

Coates Garden House is situated in Patrington, near Withernsea, in the East Riding of Yorkshire. It is set out over two floors and has eight single bedrooms. There are shared bathroom facilities and various communal areas for people to use. The service provides support for up to eight people with learning disabilities and mental health conditions. It is within walking distance of local amenities. At the time of our inspection there were seven people living at the service.

During our previous inspection on 15 April 2015, we found the provider had failed to implement and record robust pre-employment checks to ensure care workers were of a suitable character to work with vulnerable people before commencing their role.

At this inspection we saw recruitment processes ensured people were not exposed to care workers who had been barred from working with vulnerable adults this helped to ensure that only care workers deemed suitable were employed. These checks had been completed before care workers commenced their role.

We were supported during our inspection 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 and associated Regulations about how the service is run. The registered manager will be referred to as 'manager' throughout the report.

People told us they felt safe living at the home with the care workers who supported them. Care workers had received training in safeguarding adults from abuse and harm. Systems and processes were in place to ensure any concerns were reviewed and escalated for further investigation and actions were implemented to mitigate re-occurrence and to help keep people safe from avoidable harm and abuse.

The provider had completed risks assessments for the home and for people who lived there. Care and support was provided based on the assessed risks which meant people could live their lives safely without undue restrictions.

People received their medicines as prescribed and safe systems were in place to manage people's medicines. Care workers were trained in medicine administration and their competency was checked. Audits had been introduced for the management and administration of medicines to ensure people received their medicines in line with their prescription and to ensure they were managed according to best practice guidance.

There were enough care workers to meet people's needs. People received support from care workers who respected people’s dignity and privacy and promoted their independence, following their wishes and preferences.

Care plans were managed electronically and information was person centred. People had been involved in their care planning and reviews. Provision had been added to the electronic records for people to sign their consent and agreement to the information held and the provider told us they would be updating this as part of people’s review of their care and support.

People were supported to pursue a wide and diverse variety of social activities relevant to their needs, wishes, culture and interests. Arrangements were in place for people to maintain links with the local community, friends and family.

The manager and care workers had an understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). At the time of our inspection no one living at the service had been assessed for a DoLS. Care and support promoted people’s independence and this was recorded in people’s care plans.

The provider supported care workers with training and supervision to ensure they had the up to date skills and knowledge to carry out their role and meet people’s individual needs.

People chose and assisted in the preparation of their food and drink and were

We visited Coates Garden House in January 2013 and identified some issues with the quality assurance processes and systems in place. The provider sent us a plan of action that addressed the issues raised. We visited again in May 2013 to check whether the improvements had been made. We also looked at other areas of compliance during the visit.

People told us they were very happy living in Coates Garden House. One person told us “The home is very fantastic”. Another person told us “I like living here, it’s nice”.

We observed positive and supportive interactions between staff and people who used the service. Care plans were being updated and were detailed and personalised.

We looked at the environment which was clean, tidy, well maintained and fit for purpose. Staffing levels were closely monitored and were adapted according to the needs of the people using the service. Staff were fully consulted before any changes were made to staffing arrangements.

We found that there were systems in place for monitoring the quality of the service provided and policies and procedures were in the process of being fully reviewed, with most having been updated since our last visit. We found records to be fully completed, accurate, appropriately stored and that they were audited on a regular basis.

During our inspection we found that people who used the service were involved in the development and updating of the care plans and had opportunities to lead their care and support. People reported that they felt respected by staff.

We found that people were able to access the appropriate level of support from staff and had a large amount of independence and autonomy which was balanced with support where it was needed. Care plans and risk assessments were regularly updated and reviewed. People were happy living in the home. One person told us “I like living here. I have my independence and support when I need it”.

When looking at the management of medication we saw records that were accurate and up to date. Systems of recording and managing medication were robust.

We looked at the support and development of staff and found this to be appropriate and well managed. Staff felt well supported and were trained appropriately.

When we looked at the quality assurance systems within the home we found that these were in need of refreshing and updating. The home was not effectively gathering input from people or staff about the care and support delivered.

We spoke with some of the people who lived at the home. One person told us they were going out to meet some friends that day. We heard them tell staff what time to expect them back.

People told us they were able to make decision about their day to day lives. They said staff were kind and supportive and that staff were always willing to help with problems. They said they were well looked after at the home.

People told us they would be happy to speak to a member of staff, the manager or the provider if they had any concerns and they were sure that their concerns would be listened to and acted upon.

The inspection took place on 15 April and was an unannounced inspection.

The last inspection of this service was on 23 May 2013 when we found the service was meeting all of the relevant requirements.

Coates Garden House is situated in Patrington, near Withernsea, in the East Riding of Yorkshire. It is set out over two floors and has eight single bedrooms. There are shared bathroom facilities and various communal areas for people to use. The service provides support for people with learning disabilities and mental health problems. It is within walking distance of local amenities There were eight people living in the home at the time of the visit.

There was a registered manager in post on the day of the inspection. 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 and associated Regulations about how the service is run.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS are part of the Mental Capacity Act 2005 (MCA) legislation, which is designed to ensure that the human rights of people who may lack capacity to make decisions are protected. Staff had completed training on the MCA.

People living in the home told us they felt safe. There were systems in place to protect people from the risk of harm and staff were trained in safeguarding adults from abuse.

People were supported by a staff team who were knowledgeable about their needs. We saw good support being provided and that people’s choices and independence were respected. There was a recruitment process in use in the home although minor improvement was required with this.

People received support with their medication needs and there were policies in place to support staff to do this effectively. Some of this information required minor updating.

Staff received training and supervision to help them with their role. They told us the manager was supportive and approachable.

People received support to be independent with their dietary needs. Professionals told us the home worked well with them to meet people’s health needs. Clear records were kept of this and professionals felt communication was good.

People were supported through a system of care planning. Their needs were clearly recorded and reviewed to make sure staff had up to date information when supporting people. People told us they felt consulted. We saw people receive individual support, which included respect for their choices and help with decision-making.

There were quality assurance and health and safety systems within the home to help make sure people’s needs were met in a safe environment.