This inspection was carried out by two inspectors who arrived at the home at 2pm. During the inspection, they spoke with the registered manager, deputy manager, area manager, three support workers and one nurse. After the visit they spoke with two relatives and the St Anne's compliance and maintenance manager by telephone. The inspectors also looked around the premises, observed staff interactions with people who lived at the home and looked at records. There were seven people living at the home on the day of the visit, one of whom was in hospital.When we visited Thornhill Road in January 2014 we found people were not protected against the risk of receiving care and treatment that was inappropriate or unsafe and accurate and appropriate records were not being maintained. We asked the provider to make improvements. We went back on this visit to check whether improvements had been made.
Before this visit we had received information of concern about the high use of agency staff at the home, people being neglected and documents not being kept updated. We looked at these issues during our visit and found no evidence to support this information.
We considered all the evidence we had gathered under the outcomes we inspected.
We used the information to answer the five key questions we always ask;
Is the service safe?
Is the service effective?
Is the service caring?
Is the service responsive?
Is the service well led?
This is a summary of what we found. The summary describes what we observed, the records we looked at and what people living at the home, their relatives and the staff told us.
If you want to see the evidence that supports our summary please read the full report.
Is the service safe?
People were cared for in an environment that was safe and secure. We saw the premises were clean and generally well maintained. One relative told us, 'There's no smell there. It's always really clean and I'm not easily pleased, believe you me.'
We found there were sufficient numbers of suitably qualified staff to meet peoples' needs. This was confirmed by the staff and relatives we spoke with. When we asked about staffing levels at the home one relative said, 'My relative certainly hasn't suffered any neglect due to a lack of staff.'
People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.
This showed us people were protected from abuse and avoidable harm.
Is the service effective?
Relatives told us they were happy with the care provided at the home and people's care and treatment needs were being met.
From our observations and from speaking with staff and relatives we found staff knew people well. Care staff were familiar with peoples care and support needs.
Staff working at the home received appropriate training to meet the needs of the people who lived there.
This showed us that peoples' care, treatment and support at the home achieved good outcomes and promoted a good quality of life for the people that lived there.
Is the service caring?
Care workers were patient and encouraging when they were supporting people. We saw people who lived at the home looked clean, well dressed and well-cared for.
We sat in one of the lounges during the afternoon of the inspection and also observed people having their evening meal in the two kitchens. We observed how staff interacted with people. We saw and heard staff being kind, attentive and patient when they spoke with people. When staff were helping people to eat their meal they were encouraging and allowed people to go at their own pace.
We saw a thank you card from a relative which said, 'Thank you for the work you put in to helping X (person's name) settle into her new surroundings. X is very contented and relaxed. It's a pleasure to be out and about again. She always looks smart whenever we turn up.'
When we spoke with this relative after the visit they said, 'She's getting superb care, she's showered every day. X even said to me, I like it there.'
The other relative, who told us they visited their daughter every week, said, 'Their care on there, it's really very good. She's improved a lot since she's been there. They've got her walking about and she never did that at the place she was at before. She's always clean and tidy and well-fed.'
This confirmed the observations we made on the day of the visit and showed us staff treated people with compassion, kindness and respect.
Is the service responsive?
We looked at two peoples' care files and saw their needs had been assessed before moving into the home. Care, treatment and support provided to people who lived at the home met their individual requirements. Care plans and risk assessments were regularly reviewed and updated, taking account of peoples' changing care needs.
From what we saw and heard during our visit we found care and support was provided in accordance with peoples' wishes. People's preferences, interests and diverse needs were also taken into consideration.
Staff said they would go to the deputy manager if they wanted to raise a concern. One support worker told us, 'Y (the deputy manager)'s a doer. One of the clients wanted a more adaptable chair. We got Y (the deputy manager) on the case and a new chair was obtained.' Another support worker told us 'When Z (person's name) went into hospital recently the registered manager met him at the hospital.' This showed us the managers at the home responded appropriately when peoples' care needs changed.
People had regular access to activities and were supported to maintain relationships with their friends and relatives. One relative said, 'They've arranged for her to have her own wheelchair as her mobility is declining.' The other relative said, 'They're well taken care of and they take them out regular. They even asked me to go with them.'
This showed us care provided at the home was organised so that it met peoples' needs.
Is the service well-led?
People were protected against the risks of inappropriate or unsafe care because the provider had effective systems in place to assess and monitor the quality of service people received.
The home had a registered manager and deputy manager in post. The registered manager had been in post for two years and told us they also managed a similar-sized St Anne's home in Halifax. The registered manager told us they split their time between the two homes. They explained the other home did not currently have a deputy so they were spending more time there than at Thornhill Road. Staff we spoke with confirmed this and said the registered manager was not on site that often, they said they usually dealt with the deputy manager. We discussed the management of the home with the area manager during our visit. The area manager told us St Anne's was currently looking into introducing a 'one manager 'one home' policy. This would ensure the registered manager at a service was on site on a daily basis.
We asked the registered manager how they obtained feedback from people and their relatives about the service. They told us the home sent out an annual survey. We looked at the 2013 responses to this survey and saw feedback about the home was all positive. For example, 'My view is that they give first class support.' When we spoke with two relatives they confirmed they were very happy with the care at the home.
Staff told us they were clear about their responsibilities and felt well supported by the managers. They said their opinions were taken into consideration.
This showed us the leadership and governance of the home assured the delivery of high quality, person centred care and promoted an open and fair culture for its staff.