Background to this inspection
Updated
10 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 checked 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 21 March and was announced. We announced the inspection because there was a possibility the registered manager would not have been available given the small number of people using the service.
One inspector carried out the inspection.
Before our inspection we reviewed previous inspection reports and notifications we had received. A notification is information about important events which the provider is required to tell us about by law.
During our visit we spoke with the registered manager, a healthcare professional, a support worker and a relative. At the time of our inspection four people were using the service.
We pathway tracked four people using the service. This is when we follow a person’s experience through the service and get their views on the care they received. This allows us to capture information about a sample of people receiving care or treatment. We looked at staff duty rosters, four staff recruitment files, feedback questionnaires from relatives and information relating the management of the home.
We last inspected the home on 16 November 2016 where we found two breaches of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014.
Updated
10 May 2018
This inspection took place on 21 March 2018 and was announced.
Thistledown is registered to provide accommodation and support for a maximum of six adults who have learning disabilities. At the time of our inspection four people were using the service.
Thistledown 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.
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. These values were observed throughout our inspection visit.
We last inspected the home on 16 November 2016 where we found two breaches of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. We asked the provider to take action to make improvements and this action had been completed.
There is a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
Safe arrangements were in place for the selection and recruitment of staff.
The provider had arrangements in place to safely support people with their medicines.
There were effective arrangements were in place to reduce the possibility of infection.
Staff received training appropriate to peoples’ needs and were regularly monitored by a senior member of staff to ensure they delivered effective care.
Staff were knowledgeable about the requirements of the Mental Capacity Act 2005 and worked with advocacy agencies, healthcare professionals and family members to ensure decisions made in people’s best interests were reached and documented appropriately
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 protected from possible harm. Staff were able to identify the different signs of abuse and were knowledgeable about the home’s safeguarding processes and procedures. They consistently told us they would contact CQC and the local authority if they felt someone was at risk of abuse. Notifications sent to CQC and discussions with the local authority safeguarding team confirmed this.
Staff interacted with people and showed respect when they delivered care. Relatives and healthcare professionals consistently told us staff engaged with people effectively and encouraged people to participate in activities. People’s records documented their hobbies, interests and described what they enjoyed doing in their spare time.
Records showed staff supported people regularly to attend various health related appointments. Examples of these included visits to see the GP, hospital appointments and assessments with other organisations such as the community mental health team.
People received support that met their needs because staff regularly involved them in reviewing their care plans. Records showed reviews took place on a regular basis or when someone’s needs changed.
The service had an open culture where people told us they were encouraged to discuss what was important to them. We consistently observed positive interactions between staff and people. People were supported to participate in a wide range of activities they had chosen.
There were effective arrangements in place to investigate and respond to complaints.
The provider was open and honest about the improvements they wanted to make and provided examples where they had learnt lessons and implemented change.
Appropriate arrangements were in place to support people towards the end of their life.