Options Thorpe House

Updated 19 November 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was completed by three inspectors, and one medicines inspector.

Service and service type

Options Thorpe House is a ‘care home’. People in care homes receive accommodation and nursing or 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced. However, we gave the service notice of the inspection on our arrival. This was because we had to gather information on the home's current COVID-19 status and the providers procedures for visiting professionals.

Inspection activity started on 20 September and ended on 4 November 2021. We visited the service on 20 September, and 5 October 2021.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection

We spoke briefly with one person who used the service. We are improving how we hear people's experience and views on services, when they have limited verbal communication. We have trained some CQC team members to use a symbol-based communication tool. We checked that this was a suitable communication method and that people were happy to use it with us. We did this by speaking to staff and the people themselves. In this report, we tried using this communication tool with a further three people to tell us their experience.

We made some observations of the interactions between people and support staff during our inspection to help us understand their experience of care.

We spoke with four members of staff including the registered manager, deputy manager, house manager and a support worker.

We reviewed a range of records. This included three people’s care records and ten medication records. accident and incidents, safeguarding, and a variety of meetings.

After the inspection

We continued to seek clarification from the provider to validate evidence found. A variety of records relating to the management of the service, including staff recruitment, training data, quality assurance records, and policies and procedures were reviewed. We spoke with five relatives, and four further support workers by telephone, and email. We received feedback from seven health and social care professionals who regularly work with the service, four of these worked for the provider.

Updated 19 November 2021

About the service

Options Thorpe House is a care home providing accommodation and personal care to ten adults with a learning disability or autism, and complex health needs. The service can accommodate a maximum of 11 people.

The service is located in a large building within its own grounds with accessible gardens. The accommodation comprises of nine flats over two floors. There are eight single occupancy flats, and one shared flat; all with bathrooms. The service has a sensory room on the premises which is separate from the main building.

People’s experience of using this service and what we found

Feedback highlighted concerns about low staffing levels and the impact this had on staff morale in the service. The provider had taken measures to improve recruitment and retention of staff, but this was a recent initiative and it was too soon to see evidence of the impact this would have.

Training completion levels in subjects specific to peoples diagnosis were found to be low in some areas. We made a recommendation about this.

The service was safe for people to live in, and staff to work in. Risks to people were assessed which enabled them to take acceptable risks and live safely. People were protected from risks associated with the spread of infection. Medicines were safely stored and administered as prescribed.

People could show behaviour of distress at times which placed them, the staff and others at risk of harm. Guidance was in place on how staff were to manage incidents. The registered manager and provider monitored, and analysed incidents and they were used as opportunities for learning, and improvements put in place.

Relatives told us that their loved one was safe living at Options Thorpe House. Staff were aware of their responsibilities and knew what action to take should they suspect any form of abuse.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People's needs were assessed before they moved into the service. Care plans were personalised.

People's relatives told us staff were kind, and supportive. People were encouraged to express their views and were involved in making decisions about their support including reviewing their care, or deciding what activities to take part in.

People had been supported to increase their independence and learn new skills for example preparing food, drinks and recycling. They were supported to communicate with a range of tools including picture cards, so they were able to express themselves.

There were multiple healthcare professionals involved in people's care and providing joined up care. People were supported to live healthy lives and eat and drink adequate amounts.

Consideration was given to people's specific interests.

Areas of responsibility and accountability in the home were clear, and the service quality regularly reviewed. Staff and relatives said the registered manager was approachable and felt they would be able to raise any issues. Registration requirements were met.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture. People were supported in the least restrictive way possible to make choices and received care and support that was person centred and promoted independence and dignity.

Observations and records showed that people were encouraged to be independent and to make choices about their care, and care planning was person centred. Individual communication needs were considered to support people to be involved in their care, and information was presented in alternative formats.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Outstanding (published 30 August 2017).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.