Tyrwhitt House

Updated 12 October 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

We visited Tyrwhitt House on 6 September 2016. The inspection was carried out by one inspector and a specialist nurse inspector who had knowledge and skills of working with military veterans who had PTSD. The inspection was unannounced.

Before visiting the service we reviewed information we maintained about the service such as previous inspection reports, and notifications of incidents. A notification is information about important events which the service is required to send us by law. This enabled us to ensure we were addressing potential areas of concern.

During the inspection we spoke with five people who used the service. We had contact (either through email or speaking to) with eight people who used the service, currently or in the past, and one relative. We also spoke with the registered manager and six members of staff. Before the inspection we had written contact with one external professional. We inspected the premises and observed care practices during our visit. We looked at three records which related to people’s individual care. We also looked at three staff files and other records in relation to the running of the service.

Updated 12 October 2016

Tyrwhitt House is a service which provides accommodation for up to 33 people. The service provides support and treatment for veterans of the British armed forces who are suffering from post-traumatic stress disorder (PTSD).

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. 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.

We inspected Tyrwhitt House on 6 September 2016. The inspection was unannounced. The service was last inspected in September 2014 when it was found to be meeting the requirements of the regulations.

People stayed at the service for either a two or a six week period to undertake therapeutic programmes to assist them to recover from the symptoms of Post-Traumatic Stress Disorder (PTSD) and other mental health difficulties such as anxiety and social avoidance. Four therapy programmes were offered, a two week Trans diagnostic programme, a two week Anger Management programme, and a six week intensive therapy programme. The treatment consisted of individual therapies such as talking treatments such as Cognitive Behaviour Therapy and Eye Movement Desensitisation and Reprocessing; leisure, education and Occupational Therapy; and medicine review.

People told us they felt safe at the service and with the staff who supported them. People told us, “I have the utmost respect and praise for every person who works (at Tyrwhitt House)…together they make (Tyrwhitt House) work in the best way possible,” and “I can honestly rate the service they have provided as excellent. The professionalism and dedication of all the staff…was first class and has helped tremendously in my recovery. ” A health professional told us “Staff seem very caring and the people receiving care seem very happy with the help they have received.”

Most people self-administered their medicines, and there were suitable procedures to ensure this happened appropriately. Where staff were involved in the administration of medicines, people told us they received their medicines on time. Medicines administration records were kept appropriately and medicines were stored and managed to a good standard.

Staff had been suitably trained to recognise potential signs of abuse. Staff told us they would be confident to report concerns to management, and thought management would deal with any issues appropriately.

Staff training was delivered to a good standard, and staff received updates about important skills such as first aid and safeguarding at regular intervals.

Recruitment processes were satisfactory as pre-employment checks had been completed to help ensure people’s safety. This included written references and an enhanced Disclosure and Barring Service check, which helped find out if a person was suitable to work with vulnerable adults.

People had access to medical professionals such as a general practitioner. People said they received enough support from these professionals.

There were enough staff on duty and people said they received timely support from staff when it was needed. We observed staff being attentive to people’s needs.

The service had a suitable therapy programme. People said the treatment programme was of great assistance to them. For example one person said, “I received treatment for many aspects of PTSD. All treatments seemed to have worked and I have learned more strategies…to cope with my symptoms,” and “An amazing course of treatment which from the outset made me feel safe for the first time in many years. Very caring and knowledgeable staff. An amazing stay which I would highly recommend. I praise all staff.” Suitable recreational activities were also available including a library, an occupational therapy workshop, a gym, relaxation room, gardening activities, internet access and TV room.

Care records were managed electronically. Records for each person included a care plan and risk assessments. Records were regularly reviewed. People who attended the programmes on offer needed to have mental capacity, but staff had suitable knowledge about the Mental Capacity Act (2005).

People were very happy with their meals. Everyone said they always had enough to eat and drink. Comments received about the meals included, “The food is of excellent quality and in good supply.”

People we spoke with said if they had any concerns or complaints they would feel confident discussing these with staff members or management. One person said, “ I was fully informed of the complaints system, and I believe complaints would be dealt with fairly and professionally .”

People felt the service was well managed. We were told the management team were, “Very helpful and approachable. They would also approach us and ask if everything was ok.” There were comprehensive systems in place to monitor the quality of the service.