Thera East Anglia

Updated 8 January 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The majority of Thera locations, including Thera East Anglia, are registered in Grantham, Lincolnshire, despite the organisation being responsible for other locations in different parts of the country. Due to this, a decision was made by CQC to co-ordinate inspection activity at a number of Thera locations. A head office visit was carried out on 16 September 2019 by a team of inspectors prior to locations being inspected. The information from this visit fed into each of the location inspections.

One inspector visited five supported living services across Cambridgeshire and Norfolk and met with people who used the service and staff. Following our visits, an Expert by Experience made calls to people’s relatives to seek their feedback. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service provides care and support to people living in a number of supported living settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service had four managers registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service notice of the inspection. This was because the service is large, wide spread across two counties and we wanted to be sure there would be people at home to meet with us.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authorities and healthcare professionals across Cambridgeshire, Peterborough and Norfolk who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

During the inspection visits, we met with 15 people who received care and support from Thera East Anglia. However, due to their complex communication styles we were unable to obtain detailed feedback verbally from everyone. We spoke with 10 members of support staff, three local supported living service managers who were responsible for the day to day running of the settings and all four registered managers. We also attended one of the provider’s quarterly management meetings where we met with a further five supported living managers and two senior support workers. We also met with the nominated individual.

We reviewed a range of records. This included ten people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at additional records relating to the running of the service. We spoke with 10 relatives and received email contact from a further two relatives about their experience of the care provided. We also received feedback from five healthcare professionals.

Updated 8 January 2020

About the service

Thera East Anglia is a domiciliary care agency which is registered to provide people with personal care. The service operates in Cambridgeshire, Peterborough and Norfolk and supports people who have a learning disability. Support is provided in people's own homes which includes independent flats and supported living settings where staff support is available up to 24 hours per day. At the time of our inspection the service was providing personal care support to 108 people.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People were supported by exceptionally caring staff that knew them very well and understood how to support them to maximise their communication and opportunities. People’s independence and right to privacy were consistently respected.

People received their medication as prescribed and there were sufficient staff on duty to keep them safe and ensure their needs were met. A package of induction and training was provided to staff in developing the skills they needed to safely and effectively deliver care and support to people.

People were supported by staff who had a good understanding of how to recognise and report potential harm or abuse and were confident in local safeguarding procedures.

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used positive behaviour support principles to support people in the least restrictive way. On occasion, the service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.

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 24 October 2018). Since this rating was awarded the provider had a change to their registration that altered its legal entity. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Why we inspected

This was a planned inspection based on the new registration for this service.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Thera East Anglia under the ‘archived’ reports on our website at www.cqc.org.uk.