Archived: The Thomas More Project - 33 Fallodon Way

The Thomas More Project Care Home is registered to provide personal care and accommodation for up to 10 people who live with a learning disability. On the day of our visit there were eight people living at the home.

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

As was applicable at the last inspection people were supported by staff who knew how to keep them safe. Medicines were managed and given to people safely. Medicines policies and procedures were up to date and easily available for staff. Emergency procedures and contingency plans were in place. These help to keep people safe in an emergency. To further support people to stay safe, staff used personal protective equipment when supporting people with intimate care. Infection control guidance was in place and staff had completed training in this subject. Safe recruitment procedures continued to be in place. Staff were supported in their role with training and supervision. Staff felt well supported in their day to day roles by the registered manager.

People enjoyed the food and their dietary needs were assessed. Care plans explained how to support people with these needs. People were supported by staff who knew how to support them in this area of their life .

Staff were kind and respectful towards people. We saw staff engage with people in a warm and positive way. Staff had a very good understand of people’s body language to know how they were feeling and what their needs were.

People were supported by a staff team who were stable and had built up warm relationships with them and their relatives. They understood how to meet each person's individual needs and knew people’s routines and preferences in their daily life.

People were supported to receive care that was flexible and responsive and met their needs. Care plans reflected this. People and families were involved in regularly reviewing and updating them with the staff.

Relatives we spoke with were very positive about home. One said, “The staff here are very very good, nothing is too much trouble.”

People took part in a wide range of social and therapeutic activities. People were encouraged to maintain contact with relatives and friends.

People were also supported by a range of health and social care professionals who worked with them at the home. People were well supported and their needs had been assessed. Care plans and risk assessments set out to staff how to meet people’s needs and keep them safe.

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 this practice.

People benefited because there were effective systems to check and monitor the overall quality of care and support to make sure it was safe and suitable. This was undertaken through a range of audit systems. These checking systems picked up areas for development and improvement. When these were picked up swift actions were taken to improve the care and service even more.

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 (report published April 2017)

Why we inspected: This was a planned inspection based on the previous rating.

There was a registered manager for 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 staff knew how to support people in a way that respected their privacy and independence. The home had a welcoming and friendly atmosphere. Close contact with family members was actively encouraged. However a staff member spoke to a certain person in a way that did not protect their dignity. The remaining staff showed they knew how to communicate and respond in ways that treated people with dignity and respect.

New staff were recruited only after they had been through an in depth recruitment process. Risks to people were identified and kept to a minimum. This was done in a way that did not impact on people and their freedom of movement and independence. The staff knew what their responsibilities were in relation to protecting people from the risk of abuse. There were systems in place to support staff and people to stay safe.

Staff were trained and generally being supported to ensure they were aware of people's needs and how to meet them. However there had been a slippage in the frequency of staff supervision for three staff whose records we viewed. This could mean people were being care for by some staff who were not being fully supported and developed in their work.

People were supported to see a wide range of health professionals and they received the help they required to maintain optimum health. People were provided with a wide range of meals and drinks that they enjoyed.

People were supported with kindness by the staff. The team had built up close, relationships with the people they supported, their families and friends. The staff understood how to treat people as individuals and respected their lifestyle preferences, choices and wishes.

People who lived at the home were well supported to take part in a variety of activities of their choosing. People enjoyed the activities and the opportunities made available to them. There were links with the nearby community and people were well supported to be part of this if they wanted to be.

The care and service people received was regularly reviewed to find out what improvements were needed, and how the service could be further developed. There were quality checking systems in place to monitor the service to ensure people received care that was personalised to their needs. Audits had picked up some matters that required action, including the shortfall in frequency of staff supervision. The registered manager was acting on these issues. There were a range of checks and audits in place that ensured the on-going safety and quality of the service. These had been effective at providing assurance that the service remained good, and that the service was meeting people's needs and the regulations.

The team spoke positively about the management structure of the service and the organisation. They told us that the registered manager was a caring and supportive leader. The staff team told us they were well supported by the registered manager. The registered manager was also very positive about their role and the team that they managed. Staff said the registered manager and deputy manager were always there for them. They said both managers helped them whenever they needed advice, guidance and support.

During our inspection of 8 December 2013 we found that the provider had put in place a suitable system so that people's medicines were managed, stored and administered safely.

We spoke with two people who used the service to find out how they felt about life at the home. Both people told us that they were happy at the home. Each person told us that they liked the staff at the home. One person told us that they had a keyworker among the staff team. They said that this member of staff took them out to the pub and the shops.

The care plans we saw provided details of people's individual needs, wishes and preferences. People also told us that care was delivered in line with their preferences. We found that care plans and risk assessments had been reviewed as planned by the provider to meet people's changing needs.

The home had safe systems in place for the storing and administering of medicines and staff received appropriate training in this area. However we found that errors had been made on the medicine administration record sheets (MARS) that we looked at, and the stock levels of people's medication did not match the relevant MARS.

We found that pre-employment checks were undertaken before staff began work and there were effective recruitment and selection processes in place. People were also involved in the recruitment of staff for the home.

The provider had effective quality assurance systems in place to monitor the performance of the home. The views of people living there and their representatives were taken into consideration.

People were given information about the complaints procedure and any complaint was recorded and responded to in a timely manner.

We visited the home in October 2012 and found the service was non compliant with two outcomes 8 and 16. These were outcome 8 cleanliness and outcome 16 infection control and assessing and monitoring the quality of service provision.

The provider sent us an action plan in response to our visit and within the agreed timescales. This clearly set out how the provider was going to ensure ongoing compliance and the timescales for completion.

We looked at the systems for minimising the risks of infection and assurances in respect of quality auditing.

There were suitable arrangements in place to minimise the risks of infection and to audit the quality of the service. The provider had demonstrated compliance with the Essential Standards of Quality and Safety.

We did not speak with people who use the service in respect of these outcomes on this occasion. People's views were captured during our visit in October 2012.

People experienced care and support that was tailored to their individual needs. They were involved in making decisions about how they were supported. We observed staff supporting people in an appropriate manner ensuring their privacy and dignity was maintained.

People told us that they were confident that the service listened to them and any concerns that they had would be dealt with promptly. People told us they liked the staff that supported them.

Staff were knowledgeable about the people they supported and they were provided with training appropriate to their roles.

People were encouraged to lead full and active lives including attendance at college and social activities both in the home and the community.

People could be potentially at risk of cross infection due to the lack of guidance and monitoring by the provider. This was because of the way their toiletries were stored in the communal bathrooms.

There was a lack of quality assurance monitoring to review and improve the service. This included seeking the views of the people using the service.