Thanet House

Thanet House is a residential care home providing accommodation and support for up to six people who need support to maintain their mental health and/ or have learning disabilities. At the time of our inspection there were five people living there, one of whom received support with personal care. The care home accommodates people across two floors in a residential house in the London borough of Streatham.

People’s experience of using this service and what we found

Records were not always easily accessible as the provider was in the process of updating their recording practices to an electronic system.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

People’s care and support was person-centred, and the service placed a focus on ensuring people’s dignity and human rights were upheld. The values of the management team were imbedded within the staff team to ensure the service was inclusive, open and enabled people to reach their potential.

People received support from staff that had on-going safeguarding training to protect them from abuse. Identified risks were documented and staff given guidance on how to keep people safe. Sufficient numbers of staff were deployed to meet people’s needs. The provider’s pre-employment checks ensured only suitable staff were employed.

Training provided to staff ensured people received care from knowledgeable and skilled staff. Staff had one-to-one sessions with the registered manager to reflect on their working practices. Staff knew when to contact healthcare services for people to ensure their health and wellbeing was effectively managed. People were supported to access food and drink that met their preferences, faith needs and dietary requirements.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported practice.

Staff demonstrated a clear understanding of the people they supported and pre-assessments undertaken meant people received appropriate care for their needs. Staff treated people with respect, kindness and compassion. Where safe to do so, people were encouraged to enhance their skills and independence with a view to moving to a more independent service wherever possible. People told us they could make decisions about the care they received, and their decisions were respected.

Care was personalised and tailored to people’s individual needs. People told us they had opportunities to go into the community with the support from staff if required. People were encouraged to develop their daily living skills. People said they knew how to raise a complaint and were confident this would be addressed in a timely manner.

People and staff spoke highly of the registered manager and described them as open, hard working and a team player. Audits undertaken meant issues identified were addressed quickly to minimise any negative impact on people living at Thanet House. People were supported to develop the service through sharing their views. The registered manager was aware of their responsibilities in line with the regulations. The registered manager worked in partnership with other stakeholders to drive improvements.

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

Rating at last inspection

The last rating for this service was good (published 25 June 2016).

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Thanet House is a care home registered to provide care and support for up to six adults with mental health needs. At the time of the inspection there were six people living at the service.

The service did not have a registered manager in place. At the time of the inspection the manager had applied to be registered with the commission. 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 did not have adequate audits in place to effectively manage medicine stock. Audits carried out by staff did not always tally with the amount of medicines available in stock. Staff calculations of medicines remaining was incorrect, this meant it was difficult to ascertain if the remaining medicines were correct and if people had received their medicines as prescribed. The manager was implementing a new auditing tool for medicines, which would quickly identify errors and minimise the risk to people.

The last inspection took place on 17 July 2014 and the service met all areas inspected.

The service had comprehensive systems in place to protect people from the risk of harm and abuse. Risk assessments were in place that identified risks to people and gave staff guidelines on how to manage those risks. Staff were aware of the different types of abuse and the appropriate steps to take in reporting suspected abuse. Staff had received safeguarding training.

People’s care plans were person centred and tailored to meet their needs. Staff received guidance on how to support people according to their preferences and needs. Care plans detailed people’s history, likes and dislikes, medical needs and support requirements. Care plans were regularly updated to reflect people’s changing needs. Where possible people were encouraged to develop their care plans and their input and views were listened to and respected.

People’s consent was sought prior to the delivery of care. People were encouraged to make decisions about the care they received and their choices were respected. The manager and staff were aware of the correct procedure should someone be unable to give their consent. People were not deprived of their liberty unlawfully. The manager and staff had sufficient knowledge of the Mental Capacity Act 2005 [MCA] and Deprivation of Liberty Safeguards [DoLS] and their responsibilities within the legal framework.

Staff encouraged people’s privacy and dignity and were aware of the importance of doing so. Staff were kind and compassionate towards people in their care and encouraged positive relationships. People were encouraged to raise their concerns and complaints. People knew how to make a complaint and the manager was able to demonstrate the appropriate system for dealing with complaints in a timely manner. The service had information in the communal area of the service on how to raise a complaint.

People had sufficient amounts of nutritional food to eat and drink. The service liaised with health care professionals to support them in devising a healthy menu that met people’s dietary requirements. People were encouraged to prepare their own meals when appropriate. People’s independence was encouraged and praised. Staff supported people to participate in a wide range of both in house and community based activities.

People were supported by sufficient numbers of skilled and knowledgeable staff. The service had robust recruitment procedures in place to ensure suitable staff were employed. Staff personnel files showed the provider had received checks from the Disclosure and Barring Service [DBS], two references and photo identification prior to staff starting work. Staff underwent on-going training in safeguarding, medicines management, MCA and DoLS.

People received care and support from staff that regularly reflected on their working practices. Staff received on-going supervisions and annual appraisals. Staff spent one to one time with the manager discussing their roles and responsibilities, areas that worked well and areas where they required additional guidance and support.

The manager actively encouraged partnership working. Records showed people were supported to access a wide range of health care professionals to ensure their health needs were monitored and maintained. The manager carried out audits of the service to gain feedback and improve the quality of care. Quality assurance questionnaires were sent annually to people, their relatives, staff and health care professionals.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

On the day of our inspection, people using the service did not wish to speak to us. However, we left our contact details if they wished to call us but did not receive any calls.

Is the service safe?

Staff were knowledgeable in recognising signs of potential abuse and the relevant reporting procedures.

Risk assessments were undertaken to identify risks to people who used the service and others. Management plans were in place to address the risks identified.

Is the service effective?

Assessments were undertaken to identify people's support needs. Care plans were developed to identify how to meet people's support needs, and identify goals and targets people wished to achieve whilst at the service.

Staff liaised with people's care co-ordinator from the community mental health team to ensure people's health, safety and welfare.

Is the service caring?

Staff were kind and caring. Staff were knowledgeable of people's support needs and worked with people to achieve their goals. Staff supported people to attend appointments, and access the community where needed.

Is the service responsive to people's needs?

People were involved in decisions about their care. Monthly meetings were held with staff to discuss people's progress and identify any further support they required.

Is the service well-led?

There were processes in place to monitor the quality of service provision. The service had systems in place to obtain the views of people who used the service. Complaints were responded to appropriately and in a timely manner.

Individual care plans were in place for people using the service which addressed their care and support needs. There were crisis and contingency plans in place to identify what to do if someone's health deteriorated.

Staff at the service worked with care co-ordinators and consultant psychiatrists to ensure people's health needs were being met.

People using the service told us they felt safe staying there. People were protected from the possibility of abuse as staff were able to demonstrate knowledge in recognising signs of abuse and knew the reporting procedures.

Staff were supported and were completing a Qualification and Credit Framework in understanding working in mental health in addition to attending mandatory training on health and safety, food hygiene and safeguarding. Staff received regular supervision and appraisals.

There were systems in place to monitor the quality of service provision. People using the service were able to comment on the service they received and felt their comments were listened to.

People who use the service were well informed and involved in their care and treatment, and were happy to be at the service. One person told us, 'I've landed on my feet.'

Care plans were comprehensive and focused on individual needs. People who use the service were involved in the development and review of their care plans.

Medicines were safely administered and there were clear arrangements for ordering, recording and disposing of medicines.

Staff told us they were well supported by their manager but there was no evidence of formal support structures in place.

The quality of service provision was monitored and learning from incidents and complaints was evidenced.