Archived: Thorpe House Specialist Adult Mental Health Unit Limited

People’s experience of using this service:

People told us they felt safe at the service. Staff, relatives and professionals confirmed in their opinion people were safe.

Some risk assessments lacked the detail required to guide staff to manage the risk of harm. We have made a recommendation to seek further guidance around this.

Maintenance checks on the environment were robust and the service had an onsite maintenance person to coordinate any response required.

Systems were in place to record accidents and incidents. The management team had identified by recording near misses, and a more detailed analysis of incidents, they would have a better insight to prevent future incidents.

People were supported by staff who received appropriate training and support to carry out their roles and responsibilities. Staff felt supported by the management team.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were able to make choices and were involved in decisions about their care.

We saw people leaving the home independently and accessing the community throughout the inspection.

Staff were quick to identify changes in people’s needs and worked closely with other health professionals, so people’s health and well-being was maintained. A nutritionist had been employed to maximise people’s wellbeing through good nutrition. A “hydrations station” had recently been introduced to increase people’s fluid intake and had already had a positive impact

Staff were kind and caring, treating people with respect and maintaining their dignity. People's care and support had been planned in partnership with them, and regularly reviewed to ensure they achieved their goals. People were supported to retain independence skills and learn new skills and the service employed occupational therapists to lead on this aspect of the service.

There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received. The service had received many compliments from relatives and professionals about the quality of the care provided at the service.

The service worked in partnership with other organisations and healthcare professionals to improve people's outcomes.

The acting manager provided staff with leadership and was described as being very approachable. A range of audits and checks were undertaken to help monitor the quality of the service and new measures were due to be implemented. The management team were dedicated to ensuring they provided a high-quality service which put people at the forefront of any changes.

Rating at last inspection: Good (report published 11 November 2016)

Why we inspected: This was a planned inspection based on their previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Thorpe House Specialist Adult Mental Health Unit Limited is registered to provide accommodation/nursing care for people with mental health problems. The service is registered for 23 people. There were 20 people living there on the day of our inspection.

The service had a registered manager in post who had been registered since 2011. 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.’

Staff had received training in how to keep people safe. All the staff we spoke with demonstrated they understood how to ensure people were safeguarded against abuse and they knew the procedure to follow to report any incidents.

The service had a positive approach to risk. They assessed how people could be supported to live the life they wanted and worked with people in an enabling way when independent living had been identified as an achievable goal. They encouraged people to identify and manage their own risks.

We found the environment to be maintained to a high standard and was extremely clean with good infection control practices in place. Staff were observed to follow good practice guidelines in the management and prevention of infections.

Staffing levels were determined to support people well with their physical, social and emotional needs. They worked an on call system to ensure when people’s needs changed at short notice; there were always staff on hand to assist. The service recognised the potential of a multi-disciplinary approach and the benefits this brought to the people using the service and the staffing complement included registered mental nurses, nursing assistants and occupational therapists.

The registered manager understood their obligations under the Mental Capacity Act 2005 and Mental Health Act 1983 and worked within the legislative frameworks. Staff had received training and were fully informed of any changes at team meetings to ensure they continued to provide care within the law.

People received care and support from a highly trained, motivated group of staff. Staff received an induction and training to ensure they had the skills to meet the needs of the people at Thorpe House. Staff were supported to continually develop by obtaining nationally recognised qualifications and by on-going supervision and appraisal. They were keen to develop new skills to provide the best level of support to people.

People told us how much they enjoyed their meals and they were given appropriate and sensitive support by care staff. People told us they were offered choice about what they wanted to eat, where they wanted to eat and at what time they wanted to eat, demonstrating the service was flexible in its approach.

Staff were responsive to people’s individual needs, preferences and wishes and were passionate about providing a high standard of care and support. The service was inclusive when plans were being drawn up to ensure outcomes were achieved.

Without exception, people, their relatives and professionals told us they were very happy with the caring approach and attitude of the staff team who they described as kind and friendly. We observed caring relationships had been built between staff and people using the service and some people told us they considered staff as friends.

We observed staff knocked on doors before entering people’s rooms, demonstrating staff respected people’s need for privacy. Confidentiality was respected at all times with staff recognising the importance of keeping information about people private.

People were encouraged and supported to be as independent as possible, and the service had employed two occupational therapists to develop this area of practice. The service had invested in facilities to maximise people’s independence with the ultimate goal for some people to return to living in the community of their choice. This included four apartments and a therapeutic kitchen area. The service also devised goal orientated care plans to identify achievable targets which encouraged and motivated people to develop skills and abilities.

The home was well-led and the management team encouraged an open and transparent culture where people were able to make suggestions for change and improve the quality of the service. The senior staff were innovative and creative and constantly strived to improve the quality of people's lives, by working in partnership with other professionals and academia. Planned improvements were focused on raising the standard of service provision to be the best they could be.