Background to this inspection
Updated
27 September 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in to facilitate the inspection.
Inspection site visit activity started on 13 August 2018 and ended on 20 August 2018. We visited the office location on both days to see the manager and office staff; and to review care records and policies and procedures. We also completed a home visit to observe care and meet staff providing care and support to a person in their own home. The inspection was completed by one adult social care inspector from the Care Quality Commission (CQC)
Prior to the inspection we reviewed all the information we held about the service in the form of notifications and safeguarding incidents. We contacted the quality assurance team before our inspection to establish if they had any information to share with us. This would indicate if there were any particular areas to focus on during the inspection.
We spoke with a wide range of people and viewed certain records in order to help inform our inspection judgements. This included the registered manager, senior manager and two care staff. We also spoke with the relatives of three people.
Records looked at included four care plans, three staff personnel files, four medication administration records (MAR), training records, and any relevant quality assurance documentation.
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 arrange their own activities based on their preferences and needs. The service had also arranged trips and social activities to promote social inclusion. Relatives we spoke with were told us they thought the service was second to none in this respect.
The service had a complaints policy and we could see they had followed this and responded to people's concerns. The service encouraged people's feedback, comment cards were available in the reception area to the holiday chalets for people to complete. Relatives told us any concerns they raised had been responded to quickly.
The service had clear values and a culture which promoted equality for all people and positively valued diversity and difference. The management team sought to embed these values throughout their practice. Staff were made aware of these principles through their induction and ongoing learning.
Regular monitoring and auditing of the care and support people received ensured good standards of care were maintained. We saw how the management team had identified concerns and acted to address them. Regular team meetings ensured staff were up to date and had an opportunity to share information and learning.
The service had established partnership working and community links which had improved the quality of the service by increasing their knowledge and skills. They had links with Wigan Council, UCLAN and other organisations which shared their values and culture.