Trinity House

Updated 10 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

This inspection was carried out by one inspector.

Service and service type

Trinity House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager 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 48 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak 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 authority and professionals who work with the service. We used all this information to plan our inspection.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

Some of the people who used the service had complex needs which limited their communication. This meant they could not always tell us their views of the service. During the visit we observed how people were supported in communal areas and spoke with two people who used the service. We spoke with the registered manager, the deputy manager, a team leader, the chef and two support workers.

We reviewed a range of records. This included two people’s care records and three medicines 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 spoke with two relatives on the telephone and received feedback from two relatives via email.

Updated 10 January 2020

About the service

Trinity House is a residential care home providing personal care to seven people with a learning disability and/or autism at the time of the inspection. The service can support up to seven people.

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’s quality of life had improved significantly due to the exceptionally responsive and person-centred support they received. Proactive support strategies had resulted in a significant reduction in the number of incidents that could be distressing for people. Staff had an excellent understanding of people's needs and how they preferred and needed to be supported.

Relatives told us they felt Trinity House was outstanding in terms of exceeding their expectations in how staff met people’s specific needs. Staff did not view the complex needs of the people who used the service as a barrier to them participating in similar activities to those of their peers.

People appeared happy and relaxed with the staff who supported them. Relatives told us people were safe and our observations confirmed this. Staff understood the importance of safeguarding and were able to tell us what they would do if they had concerns about a person's wellbeing. Staff were recruited safely and people living at the service took part in the interview process. There were enough staff to meet people’s needs. Medicines were managed safely. There was a positive approach to safety and risk which was not restrictive for people.

People were looked after by staff who had the skills and knowledge to carry out their roles. Staff communicated effectively with relevant professionals to ensure people received the healthcare support they required. Staff supported people to buy, prepare and cook food. 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 were treated with dignity and respect and their independence was promoted. Relatives said staff were very kind and caring. There was a happy family atmosphere at the home. People and staff cared about each other and enjoyed spending time together. Staff understood the importance of understanding people's abilities and working with them to achieve positive outcomes.

There was a positive culture and ethos at the service which was driven by the management team. The registered manager led by example and actively promoted positive support strategies which improved people’s quality of life. Relatives felt the service was well managed and spoke positively about the changes the registered manager had made. There were effective systems in place to monitor the quality of the service. Action was taken if any issues or concerns were identified.

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.

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 7 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.