Thorndale

Updated 19 May 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 29 November,1 and 7 December 2017 and was announced. The provider was given 48 hours' notice because the service is for younger adults who are sometimes out during the day, we needed to be sure someone would be in. On 7 December 2017 we sought the views of relatives via telephone calls and emails. The inspection was undertaken by one adult social care inspector.

Before the inspection we reviewed the information we held about the service. This included the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally required to let us know about. We also contacted the local authority commissioners for the service, the local authority safeguarding team, the clinical commissioning group (CCG) and the local Healthwatch to gain their views of the service provided. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the feedback we received to inform the planning of our inspection.

We looked at the Provider Information Return (PIR), which we had asked the provider to submit to us prior to the inspection. This is a form that asks the provider to give us some key information about the service, what the service does well and improvements they plan to make.

As part of the inspection we undertook a number of different methods to understand the experiences of people who used the service. Some of the people who used the service had complex needs which limited their communication. This meant they could not always tell us their views of the service so we sought the views of seven relatives, including the views of two relatives whose family member no longer used the service.

During the visit we observed how people were supported in communal areas. We spoke with the registered manager, deputy manager and three support workers. We also spoke with the provider’s operations manager and head of care. The head of care was the nominated individual for this service. A nominated individual has overall responsibility for supervising the management of the regulated activity and ensuring the quality of the services provided.

We viewed a range of care records and records relating to how the service was managed. These included the care records of two people, the medicines records of three people and records relating to staff training, supervisions and the management of the service. We also checked the building to ensure it was clean, hygienic and a safe place for people to live.

Updated 19 May 2018

This inspection took place on 29 November, 1 and 7 December 2017 and was announced. We gave the provider short notice of our inspection due to the nature of the service. This was so the registered manager could be available to assist us with our inspection.

Thorndale 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. Thorndale provides personal care for up to six people with a learning disability and/or autistic spectrum disorder. At the time of our inspection there were five people living at the home. The home is located next door to another of the provider’s services, both of which are managed by the same registered manager and deputy manager.

A registered manager was in place at the time of our inspection. 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.

We last inspected this service on 3 September 2015 when it was rated 'Good' overall. During this inspection we found the service remained good and rated the key area of responsive as 'Outstanding.'

Relatives described the care at Thorndale as ‘Outstanding.’ Relatives told us how the service had made a huge impact on their family members by enabling them to lead full and rewarding lives and be as independent as possible. Staff did not view the complex needs of the people who used the service as a barrier to them participating in similar activities to those of their peers. Relatives told us people had access to a fantastic range of activities.

People had made substantial progress due to the use of the SMART (specific, measurable, achievable, realistic and timely) target system. These targets were a way of setting goals for people to work towards in areas that really mattered to them and which improved their quality of life. These targets and other positive proactive support strategies had resulted in a reduction in the number of incidents that could be challenging for people. The strong focus on person-centred care had an extremely positive impact on people.

People received care which was exceptionally person-centred and responsive to their needs. Staff had an excellent understanding of people’s needs and how they preferred and needed to be supported. Staff were innovative at responding to changes in people's needs and identifying new support strategies for people.

Relatives told us they were very satisfied with the service and felt their family members were safe and happy at Thorndale.

Risk assessments about people's individual care needs were in place, for example in relation to nutrition and epilepsy. Control measures to minimise the risks identified were set out in people's care plans for staff to refer to. There was a positive approach to risk management.

Each person had an up to date personal emergency evacuation plan (PEEP) which provided staff with information about how to support them to evacuate the building in an emergency situation such as a fire or flood.

There were enough staff on duty to meet people's needs. Essential staff training was up to date. Staff received regular supervisions and appraisals.

People 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 have enough to eat and drink and attend appointments with healthcare professionals.

There were appropriate systems in place to record and respond to complaints. Relatives we spoke with said they had not needed to complain and felt any concerns would be dealt with correctly.

Relatives felt the service was well managed. Staff described the registered manager as approachable and the service as well-led. There was an effective quality assurance system in place to ensure the quality of the service and drive improvement.

There was a positive ethos at the service which was driven by the registered manager and deputy manager. Staff demonstrated a strong commitment to providing good care.