Theoc House

Updated 16 May 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 1 inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Theoc House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Theoc House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who used the service and observed people interacting with staff. We spoke with 4 people's relatives. We received feedback from 7 professionals about their experience of the care and support provided by the service.

We spoke with 11 staff including the operations manager, registered manager, deputy manager, 2 senior support workers and 6 support workers.

We reviewed a range of records. This included people's care records and records of incidents and accidents. A variety of records relating to the management of the service, including the service’s action plan and recent audits were reviewed.

Updated 16 May 2023

About the service

Theoc House is a residential care home providing accommodation and personal care to up to 10 people. The service supports people living with acquired brain injury, some of whom may have mental health needs and/or physical disability. At the time of our inspection there were 7 people using the service.

Theoc House offers purpose-built accommodation with 7 bedrooms and 2 self-contained flats within the main building. One flat has 2 bedrooms, the other has 1 bedroom. All bedrooms have en-suite facilities and the option for ceiling hoists. The main house has an adapted bathroom, communal kitchen, lounge, and gym area. The main house, ground floor flat and enclosed garden are wheelchair accessible.

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

People were positive about life at Theoc House and told us they were supported by staff who were kind and respectful. We saw people were able to raise complaints and their views were listened to. People benefitted from a calm and inclusive approach where their individual needs were understood.

People’s risks had been assessed and their support plans described the actions staff should take to keep them safe and to promote their independence. Risk assessments and support plans were reviewed regularly, and timely action was taken when people’s needs changed. Staff followed advice from professionals when managing risks in relation to choking, pressure care, seizures and medicines.

One person declined to follow the specialist advice in their support plan to manage their risk of choking and we found a lack of clarity around how this risk was being managed by the service. We recommended the provider review their risk management processes to ensure these are sufficiently robust in such circumstances.

People’s medicines were reviewed regularly to ensure they remained suitable. The registered manager ensured the equipment people needed was requested and appropriately maintained. Provider policies were followed to manage environmental risks including fire and control of infection.

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. When people were unable to consent to any restrictions needed to keep them safe, capacity assessments had been completed and applications to deprive them of their liberty had been submitted.

Increased investment, improved oversight and leadership, recruitment changes, staff training and support were all having a positive impact on the service's culture. Each person had a named staff member [keyworker] who supported them with planning and decision-making. Senior staff had recently completed workshops in key-working and supervision [of staff] to strengthen performance in these areas. Progress on the service’s improvement plan was closely monitored by the provider.

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 20 September 2018).

Why we inspected

We received concerns in relation to meeting people’s care needs, safeguarding people and management of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe and well-led sections of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good, based on the findings of this inspection.

Recommendations

We recommend the provider review their processes to ensure these are sufficiently robust when people decline to follow recommended care and treatment plans.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Theoc House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.