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Inspection carried out on 29 June 2017

During a routine inspection

Timaru provides accommodation and personal care for up to six people living with a learning disability, autism or mental health needs.

The inspection was announced and was carried out on 29 June 2017 by one inspector.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

Staff were skilled in communicating with people in a way that met their needs, such as reading body language, pictures and signing, which ensured people felt valued, listened to and in control.

Staff respected people's diversity and human rights, empowering them to make choices and take control of their lives. There was an excellent focus on person centred support and staff were exceptionally committed and determined in finding ways to help people develop trust, confidence, self-esteem and achieve excellent outcomes.

Staff worked with external behaviour specialists to identify reasons for, and address people’s distress and anxiety. This had an extremely positive impact on people’s behaviours that challenged themselves and others. Robust record keeping enabled staff and health professionals to monitor the quality and effectiveness of people’s care and support and analyse any trends.

People were supported to maintain their health and well-being and received advice and treatment when required. People were offered sufficient food to eat and drink to meet their specific dietary needs.

There was a positive, supportive and open culture within the home. This was consistently commented on by relatives who told us that the staff were extremely responsive and provided personalised support that met people’s complex needs. Staff were positive about working at Timaru and felt very well supported by the registered manager. Staff felt listened to and involved in the development of the service.

People were encouraged to take part in a wide choice of activities and educational opportunities, both at home and in the community, which increased their skills and independence. People were also supported to be involved in their local community.

Safe recruitment procedures were in place and sufficient staff were deployed, including one to one and two to one staff support. People were supported by staff who had received appropriate induction, training and supervision and had the necessary skills and knowledge to meet people’s individual, complex needs.

Staff were extremely kind and caring, treated people with dignity and respect and ensured their privacy was maintained. The provider had renovated the home to meet the changing needs of people and provide them with more personal space.

Relatives and staff had opportunities to feedback their views about the home and quality of the service being provided, to help drive improvement. Robust systems were in place to monitor and assess the quality and safety of the home and these were kept under review by the registered manager and senior management team.

Individual and environmental risks relating to people’s health and welfare had been identified and assessed to reduce those risks. Regular safety checks were carried out on the environment and equipment to keep people safe. Plans were in place to manage emergencies and personal evacuation plans were in place for people.

People and staff told us they felt the home was safe. Staff had received safeguarding training and explained the action they would take to report any concerns. Complaints procedures were available and any concerns were appropriately addressed.

Effective systems were in place for the safe storage and administration of medicines, including controlled drugs. People received their medicines from staff who were appropriately trained to do so.

People’

Inspection carried out on 22 July 2015

During a routine inspection

Timaru is a residential home for people with a learning disability, autism and complex behaviours that challenge. The home is split in to two separate areas which inter-connect through a kitchen and staff area. Each area has communal living accommodation and bedrooms.

The home had a registered manager. 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 and associated Regulations about how the service is run. The registered manager was on annual leave at the time of our inspection so we were assisted with the inspection by the two deputy managers.

Staff showed a good understanding of the needs of the people they supported. Referrals to health care professionals were made quickly when people became unwell. Care was provided with kindness and compassion. Relatives and care professionals told us they were happy with the care people received and described the service as good, although we were told that more external activities would improve some people’s quality of life.

Records showed people’s hobbies and interests were documented and staff accurately described people’s preferred routines. People were supported to take part in activities both within the home and in the community, although the frequency varied depending on people’s support needs and behaviour patterns. People were offered a choice of food and drinks which were sufficient for their needs and that met their dietary requirements.

There were sufficient numbers of staff on duty to support people safely and meet their assessed needs. The provider had appropriate systems in place to recruit staff and to monitor their performance. Staff were appropriately trained and skilled to deliver safe care and received an induction before they started work which included shadowing other staff. Safeguarding people was understood by staff who knew about their responsibilities to report any concerns of possible abuse.

Care plans had been reviewed regularly and people’s support was personalised and tailored to their individual needs. There were robust systems in place to manage the ordering, storage and administration of medicines.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been authorised by the local authority as being required to protect the person from harm. We observed people’s freedoms were not unlawfully restricted and staff were knowledgeable about DoLS. Applications for DoLS had been made to the local authority when appropriate.

There were systems in place to monitor the effectiveness and quality of the service. Incidents and accidents were recorded and analysed, and lessons learnt were communicated to staff to reduce the risk of these happening again. Complaints procedures were in place although the home had not received any complaints.

Staff were actively involved in improving the service and were clear about their responsibilities. The provider understood their responsibility to inform the commission of important events and incidents that occurred within the service, such as safeguarding concerns and DoLS authorisations.

Inspection carried out on 9 April 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. We observed how staff were interacting with people and inspected records about the care that had been provided.

We found that action had been taken to ensure that the home was clean and that infection control procedures were followed. People were supported in a clean, hygienic environment and were protected from the risk of infection because appropriate guidance had been followed.

Since our last inspection staffing levels at the weekends had been increased. This helped to ensure that people were able to take part in planned activities outside of the home and meant there were sufficient staff available at all times to meet people’s needs.

The provider had taken action to ensure that records were fully completed. This helped to ensure that people were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

There was an effective system to regularly assess and monitor the quality of service that people receive. The provider had assessed the quality of the service provided and taken action to address any shortfalls that were identified.

Inspection carried out on 29 November 2012

During a routine inspection

We used different methods to help us understand the experiences of people using the service, because the people had complex needs which meant they were not able to tell us their experiences. We observed the interactions between people and staff who were supporting them. We also looked at records relating to the involvement of family members, social workers and health professionals.

We observed staff providing support to people in a friendly and respectful manner. Staff demonstrated a good understanding of people’s needs and how to meet them. Staff ensured that people were happy with the support they provided. Where people were not able to consent, the provider took action to ensure that everyone who was involved in the person’s support made decisions about what was in the person’s best interests. People were supported to follow specific diets were necessary and the home provided a varied and balanced diet for people.

Some areas of the home were not cleaned to an appropriate standard, which increased the risk of cross infection. There were not sufficient staff at the weekends to support people to take part in planned activities outside of the home. The provider had systems for storing records safely; however, records were not always fully completed. This lack of information in the records did not always protect people from the risk of unsafe or inappropriate care and support. We have told the provider to take action to address the concerns in these areas.

Inspection carried out on 6 December 2011

During a routine inspection

We did not, on this occasion, speak to people who use the service so cannot report their views.

Reports under our old system of regulation (including those from before CQC was created)