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Inspection carried out on 30 July 2018

During a routine inspection

We inspected Therese Care Home on 30 July 2018. This was an unannounced inspection.

At the last inspection, the service was rated Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection, we found the service remained Good.

Therese Care Home 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.

Therese Care Home provides personal care and accommodation for three people with mental health needs.

There was a registered manager at the service. 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 2008 and associated Regulations about how the service is run.

People using the service had lived at the service for several years and told us they felt completely at ease and settled there. They referred to the service as their home. They said staff were caring and friendly and like a family to them. They said the registered manager looked out for them and had their best interests at heart. There was a small, dedicated staff team who had also been at the service for several years, this helped to foster positive, caring relationships with people. There was a homely, friendly feel to the service.

People are 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 received support in relation to their medicines and their ongoing health needs. Staff supported people to attend any medical appointments. There was evidence that the provider worked in collaboration with community health and social care teams to provide a good service to people that met their individual needs.

Support plans were in place which reflected people’s current needs. They included details of where people needed support, their level of independence and their preferences in terms of how they liked to be supported. They included any cultural needs that needed to be respected.

People lived independent lives and were supported to access the community and to pursue any hobbies or interests.

People using the service told us they did not have any complaints but if they did, they would speak to staff or the registered manager. They felt confident their concerns would be heard.

The registered manager was aware of the responsibilities of her role. There was an open culture at the service which was reflected in the observed practice we saw on the day of our inspection.

Inspection carried out on 3 February 2016

During a routine inspection

This inspection took place on 3 February 2016 and was unannounced. The service met the regulations we inspected at their last inspection which took place on 14 November 2014.

Therese Care Home provides accommodation and support for up to three people with mental health needs. It is situated in a residential area of Tooting with good access to local shops and transport links.

There was a registered manager at the service. 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 2008 and associated Regulations about how the service is run.

People using the service told us living there felt like home and that staff were caring and treated them nicely. They told us they felt safe living there and if they had any concerns they would speak to the care works or go directly to the registered manager. They said the food at the home was nice and if they had any health concerns then staff would take them to see their doctor or other healthcare professionals.

People had the freedom to live life how they wanted and were able to go out when they wanted. People were consulted and gave their agreement to their care records and care workers asked for their consent before supporting them. The provider was aware of their responsibilities under the Mental Capacity Act (MCA 2005). Any restrictions placed on people were imposed with their informed consent and people understood these restrictions were in place to keep them safe.

There were enough staff employed to meet people’s needs and the provider undertook appropriate recruitment checks for staff, although no one had been employed recently. Care workers told us they were happy with the training they received and felt supported by the registered manager.

Care workers supported people to take their medicines which were stored correctly. Accurate records were kept when staff administered medicines. People were supported to attend healthcare appointments when needed and care records contained correspondence from healthcare professionals which indicated their healthcare needs were being met.

Care records had been reviewed recently and were up to date. They recorded people’s support needs and their level of independence which meant staff were able to support them in an appropriate manner.

The registered manager ran a service that was highly personal and one which felt homely. There was a relaxed, informal atmosphere at the service.

Inspection carried out on 14/11/2014 and 18/11/2014

During an inspection looking at part of the service

This inspection took place on 14 and 18 November 2014 and was unannounced. The service met the regulations we inspected at their last inspection which took place on 24 May 2013.

Therese Care Home provides accommodation and support for up to three people with mental health needs. It is situated in a residential area of Tooting with good access to local shops and transport links.

There was a registered manager at the service. 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 2008 and associated Regulations about how the service is run.

The registered manager who also owned the home made herself available to people using the service and staff. People and relatives that we spoke with praised her caring attitude and staff, who had worked at the service for a long time had established a close working relationship with her.

The home provided a safe environment for people to live in. People told us they felt safe living at the home and staff were aware of their responsibilities in terms of reporting any concerns.

There were enough staff to cover the needs of people using the service. People told us they were able to leave and go out if they wanted and if they needed staff support, someone would always go with them.

Staff had not attended training relevant to supporting people with mental health needs. The manager had completed training in Deprivation of Liberty Safeguards (DoLS) and caring for people with dementia. The manager demonstrated an understanding of the Mental Capacity Act (MCA 2005) and DoLS and was aware of their responsibilities in relation to DoLS and to always act in a person’s best interests.

Some people told us that although they enjoyed living at the home, they sometimes got bored and there were not enough opportunities for them to pursue their interests. Care plans did not include ways to maintain or improve people’s independent living skills.

People were not restricted from leaving the home and we observed people going out to the shops during our inspection. Staff told us that they always sought people’s consent before carrying out tasks for them such as prompting them for medicines.

People were supported to take their medicines. Medicines were stored correctly in a locked cabinet. Medicine Administration Record (MAR) charts were completed correctly.

People’s needs in terms of their nutrition were met. People told us they enjoyed the food at the home and we saw that the kitchen was well stocked.

People told us they were really happy and felt comfortable living at the home. There was a relaxed, informal atmosphere at the home. The home had recently been refurbished to a high standard and people had been given new furniture which they told us they really liked.

Inspection carried out on 24 May 2013

During a routine inspection

We spoke to three people who use the service and one staff member during our unannounced visit to Therese Care Home.

People using the service told us 'I'm well looked after here', 'I'm happy with the way things are' and 'it's alright'. Each person told us that they were treated with dignity and respect by the staff who worked there.

All three people we spoke were positive about the food provided to them with feedback such as 'good food, I like the food here' and 'the food is very good'. One person told us that staff made 'a fantastic fry up at the weekend'.

Each person we spoke to said they were happy living at Therese Care Home and clearly had their own established routines. There may however be scope for further work to take place around looking at how each day could be made different with more focus on engagement, occupation and quality of life.

Inspection carried out on 28 June and 5 July 2012

During a routine inspection

We spoke to three people who use the service and one staff member during our first unannounced visit to Therese Care Home. A second announced visit then took place to look at paperwork held by the provider.

One person who uses the service told us that the home was �a lovely place to live� and said that they were �lucky to come here�. Other comments received included �I�m quite happy� and �it�s alright�.

All three people we spoke were positive about the food provided to them with feedback such as �wonderful � the food is good� and �they are good cooks�.

Inspection carried out on 9 September 2011

During a routine inspection

People using the service told us they were happy with the care they received, and got on well with the staff. One person told us that it could be boring, and another told us that there wasn�t a lot to do but they liked relaxing. The people we spoke to said they felt safe in the home, and they could speak to the manager if they had any problems.

People�s views were supported by much of what we found during our visit. However, there were some areas where we found that improvements were necessary including the management of medicines, care planning, and staff training.