Archived: The Thimbles

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.

People told us they felt safe with staff. Relatives had no concerns about the safety of people. There were policies and procedures regarding the safeguarding of adults and staff knew what action to take if they thought anyone was at risk of potential harm.

Potential risks to people had been identified and assessed appropriately. There were sufficient numbers of staff to support people and safe recruitment practices were followed. Medicines were managed safely.

Staff had received all essential training and there were opportunities for them to study for additional qualifications. All staff training was up-to-date. Team meetings were held and staff had regular communication with each other at handover meetings which took place between each shift.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Two people living at the home were currently subject to DoLS. We found the registered manager understood when an application should be made and how to submit one. We found the provider to be meeting the requirements of DoLS. People were generally able to make day to day decisions for themselves. The registeredmanager and staff were guided by the principles of the Mental Capacity Act 2005 (MCA) regarding best interests decisions should anyone be deemed to lack capacity.

People were supported to have sufficient to eat and drink and to maintain a healthy diet. They had access to healthcare professionals. People’s rooms were decorated in line with their personal preferences.

Staff knew people well and positive, caring relationships had been developed. People were encouraged to express their views and these were communicated to staff in a variety of ways – verbally, through physical gestures or body language. People were involved in decisions about their care as much as they were able. Their privacy and dignity were respected and promoted. Staff understood how to care for people in a sensitive way.

Care plans provided information about people in a person-centred way. People’s personal histories had been recorded and their preferences, likes and dislikes were documented so that staff knew how people wished to be supported. There was a variety of activities and outings on offer which people could choose to do. Complaints were dealt with in line with the provider’s complaints procedure.

Weekly and monthly checks were carried out to monitor the quality of the service provided. There were regular staff meetings and feedback was sought on the quality of the service provided. People and staff were able to influence the running of the service and make comments and suggestions about any changes. Regular one to one meetings with staff and people took place. These meetings enabled the registered manager and provider to monitor if people’s needs were being met.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

Medication was stored securely with medicines handled and recorded appropriately. All the staff training was kept up to date and reflected the needs of the people in the home. We saw that appropriate professionals were involved in people's care, and that one of the people had been referred to a Dietician and their diet and weight was being closely monitored.

The home had emergency evacuation plans in place. People were aware of what to do in the event of a fire; one person we spoke with told us that they would, 'Go outside' when they heard the fire alarm. Staff told us that fire evacuation procedures were discussed regularly with the individuals who lived in the home.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, policies and procedures were in place. Relevant staff have been trained to understand when an application should be made and how to submit one.

Is the service effective?

During our visit we observed that staff provided support and engaged with people positively. People appeared relaxed and comfortable in the presence of staff. Speaking with staff it was evident that they understood individuals' care and support needs. Due to the nature of people's disabilities we were able to gather limited comments with the support of staff. We saw that individuals had different routines; one person told us that they, 'Were going shopping' and another that they were, 'Catching a train and going to work'. Staff had received training to meet the needs of the people living at the home.

Is the service caring?

We saw staff treated people in a sensitive, respectful and professional manner. People's privacy and dignity was respected. In people's care plans we saw that there was information about what they needed help with and how staff should support them. We saw that people had a programme of activities which involved people participating in community activities and that staff promoted choice and independence.

Is the service responsive?

The staff told us that during the handover, all the individuals were discussed which ensured that staff were updated about the support people received and any changes were updated in the daily notes. The home's routines were flexible to suit the needs of individuals and the homes staffing rota accommodated this.

Is the service well-led?

The home had quality assurance systems in place. These included peer audits which were undertaken on a quarterly basis which included health and safety, a financial review and a compliance audit. The manager also told us that a representative of the provider carried out a quality audit on annual basis. The home had weekly meetings and people who lived there could fill in an annual customer satisfaction survey to give their feedback. Families and staff met on a quarterly basis to share information and look at the service provided.

People also told us that they were happy with the environment that they lived in.

We also gathered evidence of people's experiences of the service by observing how people were supported by staff, looking at records and talking with a member of staff and the manager. We found that people's care needs were being managed safely by the service and that staff had a good understanding of their roles and responsibilities in this area.

People's rights with regard to consent were being promoted by the service and staff understood how people's capacity should be considered. One member of staff explained, "We work from the basis that everyone has capacity unless evidence indicates otherwise. At the moment everyone here has capacity".

Systems were in place that monitored the quality of service that people received and considered their views. People told us that they had regular meetings where their views and opinions were sought and acted upon.

We spoke with two members of staff. They told us that they had a good team and that they felt supported in their work. They informed us that they had received training that provided them with the necessary skills to deliver care and support to people. We asked about the people living in the house. It was clear that the staff knew them well and knew how they liked to be supported. One explained, 'Their parents have entrusted me to make sure they have the best individual care'.

The atmosphere during our visit was relaxed and warm. People took pride in their home and made us welcome.