Thomas Henshaw Court

flats inclusive of a bathroom and kitchenette. The service is registered to accommodate 44 people with dementia and/or old age,

We identified prior to the inspection that 7 people living in the service had tested positive for COVID-19.

The service had made the decision that until none of the people living in the service were testing negative for coronavirus no new admissions would be undertaken. The service supported people and their relatives to understand the isolation processes and how the service could help to alleviate them feeling lonely, such as calls with friends and loved ones and dedicated support time from staff members.

People were supported to understand and comply with visiting and social restrictions in line with all best practice guidance and this is communicated and updated as needed.

The service supported people to follow social distancing, isolating and hygiene practices as much as possible.

Disposal of used PPE prevents cross-contamination and followed relevant protocols, in particular single use items and how PPE is disposed of safely.

Risks associated with the use of agency staff have been identified and mitigated. The service has arrangements to ensure that agency staff are not working in multiple settings.

The staff demonstrated a good understanding of what and how to access local IPC resources (e.g. local health protection team) when they thought they needed advice and support

Thomas Henshaw Court is a ‘care home’. People in ‘care homes’ receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided and both were looked at during this inspection.

The service had a registered manager in post. A registered manager is a person who has registered with CQC 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.

This was an unannounced inspection which took place on 10 September 2018. The last inspection was in June 2016 when we rated the service as '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. The inspection report is written in a shorter format because our overall rating of the service has not changed since the last inspection.

We found that staff’s suitability to work with vulnerable adults at the service had been checked prior to employment. For instance, previous employer references had been sought and a criminal conviction check undertaken.

Staff had received training which equipped them with the knowledge and skills to ensure people received adequate support. All staff had completed National Vocation Qualifications (NVQs). NVQs are nationally recognised qualifications achieved through training and assessment, which help to ensure that staff are competent to carry out their job role to the required standard.

Medication was managed safely and was administered by staff who were competent to do so.

Appropriate arrangements were in place for checking the environment was safe. Health and safety audits were completed on a regular basis and accidents and incidents were reported and recorded appropriately.

Staff sought consent from people before providing support. Staff we spoke with understood the principles of the Mental Capacity Act 2005 (MCA) to ensure people consented to the care they received. The MCA is legislation which protects the rights of people to make their own decisions.

People were involved in their care and there was evidence in their care records to show that they had been consulted about decisions. Care records contained detailed information to identify people’s requirements and preferences in relation to their care.

Appropriate risk assessments were recorded which helped to keep people safe. People where referred to external health professionals appropriately, this helped to promote people's well-being.

There was no set daily routine and people had a choice in what activities they participated in each day. We saw evidence that people’s hobbies and interests were recorded and catered for. The service had recently launched a scheme to integrate activities with other services operated by the provider in the area.

People were assigned a ‘key care worker' to support them with activities in the local community. This ensured that people participated in activities which they had a genuine interest in.

Quality assurance processes were in place to seek the views of people using the service and their relatives.

We asked people about how they thought the service was managed and their feedback was positive.

Thomas Henshaw Court is a purpose built care home located in its own grounds in a residential area of Southport. It can provide accommodation for up to 44 people in self-contained flats, each of which has an en-suite bathroom and a kitchenette. There is wheelchair access throughout the building. The home is located close to local shops and is near to bus links for access to Southport town centre and surrounding areas.

There were 39 people living at the home when we carried out the inspection.

A registered manager was 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.

People said they felt safe living at the home and were supported in a safe way by staff.

The staff we spoke with could clearly describe how they would recognise abuse and the action they would take to ensure actual or potential abuse was reported. Staff confirmed they had received adult safeguarding training. An adult safeguarding policy was in place for the home and the local area safeguarding procedure was also available for staff to access.

Staff told us they were well supported through the induction process, regular supervision and appraisal. The deputy manager advised us that staff supervision was not up-to-date due to changes in staffing but said they were working to rectify this. Staff said they were up-to-date with the training they were required by the organisation to undertake for the job and training records confirmed this.

Staff had been appropriately recruited to ensure they were suitable to work with vulnerable adults. People living at the home and staff told us there was sufficient numbers of staff on duty at all times.

A range of risk assessments had been completed depending on people’s individual needs. Care plans were well completed and they reflected people’s current needs, in particular people’s physical health care needs. Risk assessments and care plans were reviewed on a monthly basis or more frequently if needed.

Safeguards were in place to ensure medicines were managed in a safe way. Medicines were administered individually from the medication trolley to people living at the home. Checks and audits were in place to monitor that medicines were managed in accordance with the home’s policy and national guidance.

The building was clean, well-lit and clutter free. Measures were in place to monitor the safety of the environment and equipment. A refurbishment programme was in place to up-grade the bathrooms in each of the flats.

People’s individual needs and preferences were respected by staff. They were supported to maintain optimum health and could access a range of external health care professionals when they needed to. Staff had a good understanding of people’s needs and their preferred routines. We observed positive and warm engagement between people living at the home and staff throughout the inspection. A full and varied programme of recreational activities was available for people to participate in.

People told us they were satisfied with the meals. We observed that people had plenty of encouragement and support at meal times if they needed it. People living at the home and their families were invited to three monthly meetings to review the menus.

Staff sought people’s consent before providing support or care. The home adhered to the principles of the Mental Capacity Act (2005). Applications to deprive people of their liberty under the Mental Capacity Act (2005) had been submitted to the Local Authority.

People described management and staff as caring, respectful and approachable. People said the service was well managed and they said their views were sought about how to develop the service.

The culture within the service was and open and transparent. Staff and people living there said the management was both approachable and supportive. They felt listened to and involved in the running of the home.

Staff were aware of the whistle blowing policy and said they would not hesitate to use it. Opportunities were in place to address lessons learnt from the outcome of incidents, complaints and other investigations.

A procedure was established for managing complaints and people living at the home were aware of what to do should they have a concern or complaint.

A wide-range of comprehensive audits or checks were in place to monitor the quality and safety of care provided. These were used to identify developments for the service.

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

This is a summary of what we found-

Is the service caring?

All care plans were present at Thomas Henshaw Court and those we observed were person-centred and up to date. Staff members were aware of people`s needs and wishes and were attentive at all times, giving encouragement when required which promoted the independence of people using services. One person using services commented, `we are very luck to be here with such lovely staff` while another said, `I am very happy here - the staff are wonderful`. We were shown a recent survey completed by people using services and noted a consistent rating of over 90% satisfaction for the care being provided at the care home.

Is the service responsive?

We were told by the provider, staff members and people using services that meetings were held at regular intervals which allowed people to express their views, concerns or complaints. If any concerns were raised an action plan was implemented immediately which was aimed at addressing the issue so the needs of people were being met in a good quality manner. One person said, `the menu was changed after one meeting at our request` which showed the provider listened to any concerns that were raised. In addition, the provider told us the medication rounds had been changed at the request of several staff members aimed at `improving the care needs of residents`.

Is the service safe?

Recruitment procedures were robust at the care home which included all necessary security checks which ensured the safety of people using services. The provider confirmed,`we always make sure we have enough staff on each shift to maintain the level of care and support for our customers`. Building security was checked on a daily basis. Safeguarding procedures were robust and staff we spoke to knew how to support and so keep people safe who were in their care. Thomas Henshaw Court was clean and hygienic, mainly because permanent house-keeping staff were employed. People said the `place is always kept immaculately clean`. Although no applications had been made to the local authority, the care home had mechanisms in place which addressed any perceived concerns related to mental capacity and the associated Deprivation of Liberty Safeguards.

Is the service effective?

We observed evidence that all people using services had received a pre-admission assessment which ensured all their care needs could be met at the care home. All wishes and preferences were respected including any spiritual requests. People and family members told us they had been fully involved in discussions related to care requirements which ensured they were met at all times in a consistent manner. Any concerns received were acted on and care plans would be amended in line with new requirements. A family member said, `we know if we had a problem we could speak to any of the staff and we know they would listen and sort it out`.

Is the service well-led?

From the care plans we observed, we saw that a multi-agency approach to providing care had been adopted at the care home. The provider said, `we have good relationships with doctors, community nurses and the pharmacist`. Quality assurance procedures were in place and regular internal and external audits were conducted which were aimed at continually improving the quality of service being provided to people using services. Following any meetings or surveys held at the care home, all concerns were recorded and acted on without delay and addressed promptly which helped maintain and improve the level of service being provided.

Throughout the day we observed people engaging in conversation with each other, and with staff. We noted that staff supported people in a discrete and respectful way.

Although there were mixed views expressed about the food, overall, people were satisfied with the meals. Arrangements were established for people to provide feedback on the food and contribute to the development of the menus.

Care records informed us that assessments and individualised care plans had been developed for each person and they were reviewed on a regular basis.

Arrangements were in place for monitoring the safety and suitability of the premises. An effective complaints process was in place and complaints were managed in a timely and efficient way.

Throughout the day we observed people spending time in various areas of the building, including the lounge and quieter areas. Some people choose to stay in their flat. Throughout our time at the home, we observed people engaging in conversation with each other and with staff.

Care records informed us that assessments and care plans had been developed for each person and these were reviewed on a monthly basis. Arrangements were in place for ensuring the environment was clean. Complaints were managed in a timely and efficient way. Both staff and people living at the home told us the staffing levels were sufficient.