This inspection took place on 14 and 16 August 2018. The first day was unannounced which meant the service did not know we were coming. The second day was by arrangement.

The Coppice is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at both during this inspection.

The service is registered with CQC to accommodate a maximum of seven people and at the time of this inspection the service was full.

We last inspected The Coppice in May 2017. At that time, we found breaches of legal requirements and the home was rated ‘Requires Improvement.’ We required the service to send us an action plan which sought to address the regulatory breaches and during this inspection we checked compliance against the action plan.

At this inspection, we found sufficient improvements had been made which meant the service was no longer in breach of regulations but areas of improvement were needed centred around 'well-led.'

We have also highlighted a recommendation for equality, diversity and human rights.

In our previous inspection report of May 2017, we noted the provider, FitzRoy Support, had started to make plans for The Coppice to close. At this inspection, we were told the provider was continuing to explore a variety of

different options for the service including alternative purchase, housing partnerships or rebuild on site. However, at this inspection we noted this issue continued to cause anxiety amongst relatives of people who used the service.’

There was a registered manager in post at the time of this inspection. A registered manager is a person who has registered with 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.

The registered manager of The Coppice was also responsible for several other services across the Greater Manchester area. This meant they could only dedicate some of their time to maintaining oversight of the service delivered from The Coppice.

We reviewed systems for audit and quality assurance and were not assured the registered manager reviewed or analysed audits in a timely enough manner to identify themes or trends that would require remedial action.

Risks to people at the home were assessed and reviewed. We found risk assessments in place in the support files we reviewed around falls, moving and handling, infection control, oral health and other aspects of personal care.

We reviewed staffing levels and found there continued to be sufficient numbers of staff to meet people’s needs. The home also continued to benefit from a number of long serving members staff who knew people very well.

Systems and procedures which sought to protect people from abuse were robust; this included for safeguarding and whistleblowing.

Where accidents or untoward incidents occurred, these were appropriately recorded and investigated with preventative measures put in place to reduce the likelihood of a reoccurrence.

Staff continued to receive training and ongoing support that enabled them to fulfil their roles and to provide safe and effective care and support. Newly recruited staff continued to receive an induction and were expected to complete the Care Certificate.

Records we reviewed showed staff received regular supervision. Supervision meetings provide staff with an opportunity to speak in private about their training and support needs as well as being able to discuss any issues in relation to their work

People’s nutritional and hydration needs continued to be met. Food was freshly cooked each mealtime and people who used the service had input into menu planning and their personal preferences were factored into this.

This inspection took place on 09 and 15 May 2017. The first day of the inspection was unannounced.

The Coppice provides 24 hour care and accommodation supporting up to seven people whose primary needs relate to their physical or learning disability. The accommodation provided includes seven bedrooms that are located on both the ground and first floor. A chair lift provides access to the first floor for people who may have difficulty climbing stairs. At the time of our inspection there were six people living at the home.

The provider informed us that they planned to close the home in the near future, although there was no definite date set at the time of our inspection. This decision had been communicated to people living at the home, relatives and staff. The registered manager told us the provider was looking for a new property in the area, which would allow people using the service to continue living together if this is what they wanted to do.

We last inspected The Coppice in March 2016 when we rated the home requires improvement overall. At that time we found one breach of the regulations in relation to gaps in records relating to fire drills and fire alarm testing. We found improvements had been made in this area, but identified other breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to providing safe care, the cleanliness and maintenance of the premises, and having suitable systems in place to monitor the quality and safety of the service. You can see what actions we have told the provider to take at the end of the full version of the inspection report. We also made one recommendation, which was in relation to ensuring people are aware of the complaints policy and procedure.

We found shortfalls in the maintenance and cleanliness of the home. The conservatory attached to the home had leaked for an extended period of time, which had resulted in damp developing in this area. Around other areas of the home we saw stained carpets, torn wall-paper and mouldy sealant around a bath.

Staff were not always effectively recognising or managing risks to people’s health and wellbeing. For example, we saw medicines delivered from the pharmacy were not stored securely, and thickening agent, which presents a potential choking risk, was left unattended in the kitchen area for a short period. We also found some staff were not aware of the level of supervision one person required when eating to help reduce the risk of them choking. The registered manager took action to address this concern by asking staff to read and sign this person’s support guidance.

Staff were aware of their responsibilities in relation to safeguarding, and were aware how to raise any concerns internally, or externally if required. We saw the registered manager had followed-up any reported accidents or incidents appropriately, and these were also monitored by the provider.

Staff told us they received sufficient training to allow them to perform their jobs competently. Records showed staff had received training in a variety of topics including safeguarding, moving and handling, communication and positive behavioural support. New staff received a thorough induction, and we saw staff competence was checked by a manager. Staff received regular supervision, and they told us they felt supported in their roles.

Staff told us they would always ask for people’s consent before providing care or treatment. Information in people’s care files provided guidance to staff on how to support people to make their own decisions whenever possible.

People were encourage to be involved in planning a menu each week. We saw people were offered choices of meal, and alternative meals were provided to people based on their preferences and dietary requirements.

There was a long-standing staff team who knew the people living at the home well. Staff were able to tell us about peoples likes, dislikes and support needs. There was one vacan

The inspection was carried out on 15 March 2016 and was unannounced.

The Coppice is a small service providing accommodation and support with personal care to a maximum of seven people with a learning disability. At the time of our inspection, six people were living at the service.

The service had 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.

People felt safe and were supported by the care staff and registered manager. However, not all safety checks had been completed, meaning people could have been at risk from harm.

Staff sought consent from people before providing care or support. The ability of people to make decisions was assessed in line with legal requirements to ensure their liberty was not restricted unlawfully. Decisions were taken in the best interests of people when necessary. However, we had not been informed where two people had a Deprivation of Liberty Safeguarding authorisation in place.

Risk assessments were not always up to date. Care plans were written with the person whenever possible and people were supported to be involved in identifying their support needs. Care plans included people’s likes and preferences and reflected any changes to the person’s needs.

Medicines were mostly administered as prescribed; when errors occurred, appropriate actions had been taken. All medicines were stored safely.

People were well cared for and there were enough staff to support them effectively. The staff were knowledgeable about the complex needs of the people and knew how to spot signs of abuse. There were robust recruitment checks in place prior to staff commencing work.

Staff had completed training appropriate to their role. Staff were observed as being kind and caring, and treated people with dignity and respect. They spoke to people with respect. There was an open, trusting relationship between the people and staff, which showed that staff and managers knew people well.

People were supported to be part of the local community and were able to attend activities both within the home, as well as in the local community. They made choices about how they spent their time and where they went each day.

We saw where people and their relatives had been asked for feedback about the service they received and any concerns were addressed promptly. Staff worked well as a team and said the manager provided support and guidance as they needed it. There was an open and transparent culture which was promoted amongst the staff team.

Staff felt the service was well-led and they were supported in their roles. Procedures were in place to learn from any incidents and there were clear actions recorded.

We identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.

On the day of our inspection we spoke with the registered manager and four support workers who supported us with our inspection.

Prior to our inspection we had been made aware of some concerns in relation to medication management, and in particular, medication errors. We looked at the systems in place to ensure people received their medication safely.

There were seven people living at The Coppice on the day of our inspection. Due to the complex health care needs of people living at the home we were only able to speak with one person who used the service. Comments from this person included; “I have lived here for two years now and I like it. I like going to the day centre, reading and going shopping. The staff look after us well and we have a laugh and a joke. I get my tablets each day and staff come with me to any appointments”.

We looked at personnel files to ensure staff had been recruited safely and we found appropriate checks had been made, and relevant documentation obtained such as CRB’s and references from previous employers.

We looked at the systems in place to both monitor the quality of service provision and deal with complaints effectively. We found there were several methods in place such as regular auditing, staff meetings and the use of a complaints log and policy and procedure.

We carried out an inspection visit to The Coppice on Monday 2nd July 2012. When we arrived at the home, we heard that three people had left for the day to attend day services. However, we spoke with two people who were getting ready to go out for shopping and for lunch.

One person told us that everyone was very friendly and they liked living at the home. They said “I have a laugh with staff and sometimes other people in the home too”. They said they felt safe at the home. We heard that they liked their bedroom. They told us that they chose the decoration and floor covering for their room.

We heard about the activities one person was involved in each week. These included dancing, cooking and art. We heard that there was a weekly meeting between people living in the home and staff. At this meeting, people planned and agreed the meal menus for the week and we heard that people also discussed holiday plans.

The other person indicated they were happy with their life in the home.

Both people told us that they were looking forward to their shopping trip and going out for lunch.