367 Thornaby Road

367 Thornaby Road is a residential care home providing personal and nursing care to four people with learning disabilities at the time of the inspection. The service can support up to five people.

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

People received kind and caring support. People and an external professional said people were happy at the service.

We have made a recommendation around accessible information. People received personalised support that reflected their needs and choices. A clear complaints process was in place.

Risks to people were assessed and addressed. Medicines were managed safely. Effective infection prevention and control procedures were in place. People were supported by staff who had been safely recruited.

Staff were supported with regular training, supervision and appraisal. The premises were adapted to meet people’s needs, and were being reviewed to see if they could be further personalised. 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.

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.

Right support:

• Model of care and setting maximises people’s choice, control and independence

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human

rights

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives

Quality assurance systems were in place to monitor and improve standards at the service. The manager and provider promoted a kind and caring culture. Feedback was sought and acted on.

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 good (published 18 August 2018).

Why we inspected

This was a planned inspection based on the previous rating.

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.

The service was last inspected in March 2016 and was rated good. At this latest inspection we found the service remained good.

367 Thornaby Road is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. It accommodates up to five people in one adapted building. At the time of our inspection five people were using the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in place. 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. The registered manager was registered in July 2018 during the course of our inspection.

Risks to people were assessed and plans developed to minimise the chances of them occurring. Systems were in place to monitor and learn from accidents and incidents. Plans were in place to support people in emergency situations. People were safeguarded from abuse. The premises were clean and tidy. People’s medicines were managed safely. The provider ensured enough staff were in place to support people safely. Robust recruitment processes were in place to minimise the risk of unsuitable staff being employed.

People’s support needs and preferences were assessed before they started using the service. Staff were supported with regular training, supervisions and appraisals. People are were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. People were supported to maintain a healthy diet. The service worked closely with external professionals to monitor and promote people’s heath. The premises were custom-built and had been designed for the benefit and convenience of people living there.

Throughout the inspection we saw numerous examples of kind and caring support being delivered. People were treated with dignity and respect. People were supported to be as independent and live as full a life as possible. People were supported to access advocacy services where needed.

People received personalised care based on their assessed support needs and preferences. People were supported to access activities they enjoyed. The provider had systems in place to investigate and respond to complaints.

The registered manager had informed CQC of significant events in a timely way by submitting the required notifications. This meant we could check that appropriate action had been taken. Staff spoke positively about the culture and values of the service and said they felt supported in their roles. The registered manager carried out a number of quality assurance checks to monitor and improve standards at the service. Feedback was sought from relatives and staff and acted on.

367 Thornaby Road is a small home providing personal and nursing care for five people with learning disabilities and additional support needs. The bungalow is purpose built, and each room has an en-suite bathroom. Two of the bedrooms are adapted to meet the needs of people with a physical disability.

The home had a registered manager in place who has been registered with the Care Quality Commission since November 2014. 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.

At our last inspection January 2015 we asked the registered provider to take action to make improvements in the management of medicines, good governance, assessing and monitoring the risks relating to the health and safety and welfare of service users, seeking and acting on feedback from relevant persons, acting on complaints and supporting staff through supervision and appraisals. The registered provider sent us an action plan stating they would be compliant by 31July 2015.

During this inspection we found that the registered provider had put systems in place to manage medicines safely. The registered provider was now assessing, monitoring and improving the quality of the service. Risk assessments were now in place to protect the health, safety and welfare of people who used the service and others. The registered provider was now seeking and acting on feedback from relevant persons. Complaints were now acted on and recorded effectively and staff were receiving regular supervision and an appraisal.

Staff we spoke with understood the principles and processes of safeguarding, as well as how to raise a safeguarding alert with the local authority. Staff said they would be confident to whistle blow (raise concerns about the home, staff practices or provider) if the need ever arose.

The registered manager had knowledge of the Mental Capacity Act [MCA] 2005 and Deprivation of Liberty Safeguards [DoLS]. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The registered manager understood when an application should be made, and how to submit one. At the time of our visit all five people living at the service were subject to a DoLS authorisation.

Accidents and incidents were monitored each month to see if any trends were identified. At the time of our inspection the accidents and incidents were too few to identify any trends.

Staff received relevant training and competency assessments took place in subjects such as safe handling of medicines..

Staff were observed to know people well and to be caring and respected people’s privacy and dignity.

People were supported to access healthcare professionals and services.

Activities took place more on a one to one level with the occasional group outing to the beach. People who used the service had a busy social life.

People’s care records were person centred. Person centred planning (PCP) provides a way of helping a person plan all aspects of their life and support, focusing on what’s important to the person. Care plans provided evidence of access to healthcare professionals and services. Care plans contained relevant risk assessments.

We found people were cared for by sufficient numbers of staff. Recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.

We saw that the service was clean and tidy and there was plenty of personal protection equipment (PPE) available.

People were provided with a meal choice and enjoyed the food on offer.

Staff were supported by the registered manager and were able to raise any concerns with them.

We saw safety checks and certificates that were all within the last twelve months for items that had been serviced and checked such as fire equipment and water temperature checks.

We found people who used the service had safe and appropriate care, treatment and support. This was because their individual needs were established from when they were referred to or began to use the service. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.