Thorne House

Updated 13 December 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection was under taken by two adult social care inspectors.

Service and service type

Thorne House is a ‘care home.’ People in homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and care provided, and both were looked at during this inspection.

The service specialises in providing care and support to people with learning disabilities and other complex needs, such as autism. The accommodation is a very large family home set in its own grounds, which is , adapted and divided in to five apartments.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We visited the service on 15 October 2019. This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. This included reviewing any notifications of accidents and incidents from the provider and information we received from external agencies. We sought feedback from the local authority. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with five people who used the service and one visiting relative about their experience of the care provided. We spoke with seven members of staff including the registered manager, senior care workers and care workers. We also spoke with senior managers who attended to support the inspection. This included the head of care services and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included two people’s care records and several medication records. We looked at two staff files in relation to recruitment training and support. A variety of records relating to the management of the service, including quality audits, staff meetings and other records about the management of the service were reviewed. We spent time observing interactions between staff and people who used the service.

Updated 13 December 2019

About the service:

Thorne House is a care home providing care and support for up to 18 people living with learning disabilities and autistic spectrum disorder.

The service is a large home, bigger than most domestic style properties. It is registered for the support of up to 18 people and 17 people were living there at the time of our inspection. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the service working hard to make sure outcomes for people reflected the principles and values of Registering the Right Support. There was a very strong focus on promoting people’s choice and control, independence and inclusion. People's support very clearly focused on them having as many opportunities as possible for them to gain new skills and become more independent.

We found the outcomes for people using this service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used positive behaviour support principles to support people in the least restrictive way. The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.

People’s experience of using this service:

The service continued to be outstandingly responsive and to celebrate people’s achievements in a way that helped people to grow in confidence, maturity and skills. Staff successfully promoted people’s independence and as a result, some people had become much more independent and had much richer lives.

The provider had continued to ensure people received care and support that was exceptionally personalised, very well planned and particularly responsive to their needs. People’s individual support plans were very person centred and well designed to meet people’s communication needs. Staff sought opportunities for people to have different experiences and to do things in the community. People had their own interests and hobbies and took part in many activities. We saw instances where employment opportunities had given people a sense of self-worth and confidence. People were supported to maintain their family relationships and friendships and make new friends.

People were safe, protected from avoidable harm and risks were well managed. There were enough staff on duty to ensure people’s needs were met and they had been recruited in a way that helped to keep people safe. Staff had a clear understanding of safeguarding people and of the action they should take if they suspected any abuse. People's medicines were managed well,

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 maintain a balanced diet and received on going healthcare support. Staff received appropriate training, support and supervision. Although homely, in some places the environment needed attention and refurbishment. This was being actively addressed by the management team.

People were treated with understanding, dignity and respect and supported to make day to day choices and decisions. There was an effective system to manage complaints.

People’s views were regularly sought about the quality of the service. There was a focus on treating people with equality and on involving and empowering those with communication difficulties, to ensure their voices were heard and valued. Staff and relatives we spoke with felt the service was well led and the registered manager was approachable and listened to them. There was an open and transparent management of the service, with very comprehensive checks and audits to maintain quality and safety.

Leadership was of good quality and people who used the service, their relatives and representatives were involved in how the service was run and operated. staff felt supported and spoke positively about the provider and the registered manager.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

The service was rated good at the last inspection in February 2017 (published March 2017).

Why we inspected:

This was a planned inspection based on the rating awarded at the last inspection.

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.