We inspected the service on 15 June 2016 and the visit was unannounced. At the last inspectionon 14 November 2014 we asked the provider to take action to make improvements. We asked them to improve their practices in relation to obtaining people’s consent to their care. Following that inspection the provider sent us an action plan detailing what improvements they were going to make. At this inspection we found the provider had made the required improvements and the regulations were being met.
Thornham Grove Care Home is a registered care service providing care for up to 34 older people. At the time of our inspection 33 people were using the service, some of whom had dementia. The service is on one level and split between four areas. Each area has its own lounge and dining areas. All bedrooms are single occupancy. There is also access to a garden area for people to use should they wish to.
The service had a registered manager. It is a requirement that the home has a registered manager. 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 2008 and associated Regulations about how the service is run.
People felt safe and staff knew how to protect them from abuse and avoidable harm. People were supported to remain safe as the provider had carried out regular checks on the equipment they used and the premises.
The provider had managed risks that people were vulnerable to. For example, where people were at risk of skin damage this risk had been carefully considered with instructions for staff to follow when supporting people with their skin care needs. The registered manager had analysed accidents and incidents to look at ways to prevent them from reoccurring where possible.
People had mixed views on the staffing levels within the home. We found that staffing levels were adequate. The provider told us that they would look at ways for people to summon assistance when they were alone in the lounges. The provider recruited staff safely.
People’s medicines were being handled safely. For example, staff received regular guidance on how to administer people’s medicines.
People were supported by staff that had received regular training and support. The registered manager had regularly checked the competency of staff to undertake their roles.
Staff understood the requirements of the Mental Capacity Act (MCA) 2005 and people’s consent had been obtained wherever possible for their care and support. Where people may have lacked the capacity to make their own decisions, the provider had followed the requirements of the MCA. For example, mental capacity assessments were in place.
People were satisfied with the food and drink offered to them. Where people required specialist support to maintain their health and well-being this had been requested and was in place.
People had mixed views about the caring approach of staff. We found staff to be supporting people in a kind way. For example, staff spent time with people when they were confused.
People’s dignity and privacy was being respected by staff who knew, for example, how to keep their sensitive information secure and how to involve them in making decisions where possible.
People’s preferences were known by staff. This included their communication needs and things that mattered to them. People were supported to maintain relationships with people that were important to them. Staff made visitors feel welcome.
Where people could, they had been involved in and contributed to the planning and reviewing of their care and support. Where this had not been possible, their relatives or representatives had been included. People had information about independent advocacy services to help them to speak up if they had required this support.
People’s support plans were mainly focused on them as individuals and we saw that staff worked in a person-centred way with them.
The provider had considered the needs of people with dementia by making the home easier for people to find their way around. For example, different parts of the home were decorated differently and there were signs and photographs to aid people’s orientation.
Some people had access to activities that they were interested in. An activities organiser had recently been recruited to help more people to undertake hobbies and interests that they enjoyed.
People and their relatives had opportunities to give feedback about the quality of the service. For example, questionnaires had been given to them in the last 12 months; the results of which had been displayed. People and their relatives knew how to make a complaint.
People and their relatives described the service as well-led. Staff were involved in the development of the service and the provider sought feedback of the quality of the service being provided. The registered manager took action where necessary following feedback received.
The registered manager was aware of their responsibilities and had arranged for quality checks of the service to take place to make sure that it was of a high standard. For example, checks on people’s medicines and their care records had been undertaken.
Staff told us that they were supported and we saw that the provider had processes in place to make sure that this occurred. Staff understood their responsibilities including reporting the poor practice of their colleagues should they have needed to.
There was a shared vision of the service by the registered manager and staff members. This included respecting people’s wishes and offering them choices in their daily lives.