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Thompson House Equestrian Centre Good

Inspection Summary


Overall summary & rating

Good

Updated 27 September 2018

This inspection took place on 13 and 20 August 2018. We announced the inspection in advance because the service is small and we wanted to be sure the manager would be available to facilitate the inspection. this was the services first inspection since registering with CQC in July 2017.

Thompson Equestrian Centre provides personal care and support to people living in their own homes in the community. They also provide care and support to people staying in the holiday chalets, on the site of the equestrian centre, for respite. Some people who stayed in the holiday chalets were supported by their own staff but if required the service could arrange to provide care and support to people who came on holiday. At the time of our inspection the service supported six people living in their own homes and 12 people who were using the respite service.

There was a registered manager in post. 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 service had effective systems in place to protect people from the risk of harm and abuse. Staff were knowledgeable about how to recognise and respond to concerns. We could see the service had been thorough in investigating and following up all concerns raised.

Staff had been recruited safely, all the necessary checks had been completed to ensure staff were suitable to work with vulnerable people.

Staff were identified to work with people based on the persons specific needs and preferences. We saw how this matching process had significantly improved the quality of people's lives and reduced some of the risks associated with supporting people who might have behaviours that were challenging.

New staff received a comprehensive induction programme and regular training. Specific training tailored around individual peoples' needs and preferences had been developed and provided. Relatives we spoke with told us they were confident staff had received effective training and were knowledgeable about individual people.

Where the service was responsible, people had been supported to maintain their health needs and had access to health professionals when needed. The service ensured information about health needs and how to support peoples' communication and decision making had been developed should people need to go to hospital to ensure there were smooth transitions between services.

Relatives of people accessing the service told us they thought the staff were caring. We observed staff were kind and patient when interacting with people and each other. People were supported in ways that maintained their dignity and promoted their choice and control when receiving care and support. People were supported to communicate their needs and wishes, staff took the time to learn how best to do this to optimise people's involvement in decision making.

People received personalised care that was responsive to their needs. Care plans included clear information about how people preferred to be supported. People's needs were reviewed and updated regularly. Both care plans and reviews had been completed with significant input from families and other professionals. Relatives told us they felt fully involved and able to raise anything at any time about their relatives' care.

There was a broad range of activities available, the holiday chalets were on the site of the equestrian centre which had large grounds and opportunities to get involved with feeding the animals and collecting eggs. Day services were also separately available on site. People using the holiday chalets had support to engage in activities of their choosing, including shopping, going to the cinema, pubs and day trips. People living in their own homes had been supported to arr

Inspection areas

Safe

Good

Updated 27 September 2018

The service was safe.

The service had safeguarding policies and procedures which were aligned with Wigan Council. Staff were knowledgeable about how to ensure people were protected form the risk of harm and abuse. Relatives we spoke with felt confident that people were supported safely.

Risk assessments had been completed to support people to manage the risks in their daily lives. The risk assessments ensured people were supported in ways that were not restrictive.

Medicines were managed and monitored safely. Clear recording showed medicines were being administered correctly. Where people had covert medication this had been properly agreed with medical professionals.

Effective

Good

Updated 27 September 2018

The service was effective.

Staff had received induction training and ongoing mandatory training to ensure they had the skills and knowledge to support people effectively. Training around the specific needs for some people had involved the person and their families to maximise the staffs knowledge of the them.

The service were aware of their obligations in relation to the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards. They had received training from Wigan Council and were aware of when they might need to apply for a DoLS authorisation. Staff understood the importance of gaining consent from people when providing personal care and ensured they achieved this by using effective communication.

People were supported to maintain their health and wellbeing. The service had sought alternate ways to explore people's wishes in ways that involved them in setting their own health and wellbeing goals.

Caring

Good

Updated 27 September 2018

The service was caring.

Relatives we spoke with praised the caring attitude of the staff and management team.

People were supported by staff who maintained their dignity and respect. They achieved this by understanding the persons' needs and ensuring they met them in the way they preferred.

People were supported to communicate their needs and wishes. The service had made a particular effort to learn and understand the different ways people using the service expressed themselves.

Responsive

Good

Updated 27 September 2018

The service was responsive.

People received care that was personalised and responsive to their needs. They had been involved in developing their care plans by staff gathering information over time about how they preferred to be supported. Relatives were closely involved in care planning and reported feeling able to raise anything at any time.

Records in daily notes were detailed and informed future reviews and care planning.

A broad range of activities were available which reflected individuals wishes and preferences. The service sought to develop inclusive activities and to broaden people's social lives and presence in the community.

Well-led

Good

Updated 27 September 2018

The service was well led.

The registered manager was approachable and knowledgeable. They promoted a clear culture and set of values based on the citizenship model, which promotes the equality of all people and positively values diversity and difference. Staff were aware of these and received training and guidance to embed these principles.

Staff and relatives told us they felt the service was well led and had confidence in the registered manager. Relatives felt comfortable raising anything at any time. Staff felt they were well supported and knew what was expected of them.

Effective governance by the registered manager ensured the service continued to provide high quality care and support. Regular audits of records, spot checks and observations ensured the registered manager had good oversight of what was happening and where any areas may need further attention.