The last inspection of this care home took place on 15 April 2014. The service met the regulations that we inspected at that time.This inspection took place on 31 May 2016 and was unannounced.
14 Thornhill provides care and support for up to six people who have autistic spectrum conditions. The service is situated near other care homes operated by the same provider. The home does not provide nursing care.
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.
During this inspection we found that the service had not told us about two incidents that had been referred to the safeguarding team at the local authority. Although these were low level events, it is a legal requirement that registered services inform CQC of any alleged safeguarding events. This had been a management oversight, as similar incidents had been reported the previous year and the correct notification had been submitted to the Care Quality Commission (CQC). We have written to the provider about this outside of the inspection process.
The people who lived at the home had complex needs that meant they were unable to fully express their views. We saw people were relaxed and comfortable in the presence of staff and actively sought out staff members to spend time with them.
All staff had training in safeguarding and understood how to report any concerns. Relatives and staff felt there were enough staff on duty at all times to make sure people were safe.
Staff were vetted before they started work at the service to make sure they were suitable to work with vulnerable adults. The staff managed people’s medicines in a safe way for them.
Relatives said the staff were well trained in autism and said their family members’ “complex, specific needs are met”. New staff received induction training when they started work. One staff commented, “We get all the up to date training we need.”
Staff had training in the Mental Capacity Act 2005 for people who lacked capacity to make a decision and deprivation of liberty safeguards to make sure they were not restricted unnecessarily. People’s lack of capacity to consent to care was clearly outlined in their care records.
People were supported to maintain a balanced and healthy diet. People's health and well-being was kept under continuous review by the service with input from external healthcare professionals.
Relatives told us their family members were cared for at the service by staff who were “respectful and kind”. A relative commented, “Our [family member] is very happy at number 14 and has a very good relationship with staff as do we.”
Staff members felt their colleagues were caring and committed to supporting people who lived there. Staff spoke about people in a way that valued them as individuals. Staff supported people in a friendly and encouraging way that met their individual communication needs.
People had been individually assessed and their care was planned to make sure they got the right support to meet their specific needs. Records described how people were not fully involved in their support plans because of their complex needs. Relatives felt they were able to discuss their family member’s support at any time.
Staff members were clearly knowledgeable about the specific and individual ways of each person. One staff member commented, “We work very closely with each person so we know their ways and what it means. I know the things they like and don’t like and can spot the slightest change in them.”
Staff were also familiar with how people might show if they were unhappy with a situation. Relatives had up to date information about how to make a complaint or comment. They said they would be comfortable about telling the registered manager if they had any concerns.
Relatives and care professionals felt it was a well-run home. They told us they thought the home’s management team were approachable and open to their suggestions. For example, one relative told us, “We have found [registered manager] and [assistant manager] are good leaders, approachable, helpful and caring.”
The registered manager agreed it would be better if people had more regular chances to sit with staff and discuss the service and things they would like, and this was now in their diaries.
Staff felt supported and were kept informed about any changes to the service. The provider had a quality assurance system to check the quality and safety of the service provided.