Thera East

Updated 22 August 2019

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 inspection team included two inspectors and two Experts by Experience who made phone calls to people and family members. 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 is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

This service also provides care and support to people living in 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 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. In the past there had been one registered manager. Due to the size of the service, there were now four registered managers, with plans for a fifth. Two registered managers had left in 2019 and the provider was in the process of recruiting replacements.

Notice of inspection

This inspection was announced. We gave 24 hours notice of the inspection as we needed to make sure the right people were available to answer our questions.

Inspection activity started on 21 June 2019 and ended on 1 July 2019. One inspector visited the office location in Grantham on 26 June 2019. Two inspectors visited four locations where the service provided care and support on 24, 28 June and 1 July 2019.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authorities and professionals 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. We used all this information to plan our inspection.

During the inspection

We met or spoke with eight people who used the service and fourteen relatives about their experience of the care provided. We spoke with the director, two registered managers and staff relating to learning and development, human resources and quality management. We met with front line staff, including three senior staff and seven care staff.

We reviewed a range of records. This included four people’s care records. We looked at a variety of records relating to the management of the service.

After the inspection

Following our visit to the service we requested further information from the provider to inform our judgements. We spoke with five professionals who work with the provider and or local staff to ask for feedback on the quality of the service.

Updated 22 August 2019

About the service

Thera East is a domiciliary care agency which is registered to provide people with personal care. The service operates in Essex and Suffolk and supports people living with learning disabilities. Support is provided in people’s own homes which includes family homes, independent flats and supported living schemes where staff support is available up to 24 hours per day. 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.

There were 182 people receiving personal care from the service at the time of our inspection

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

The provider promoted a service which was centred on the people being supported. The management of the service had changed since our last inspection. There was now a larger management team, which was improving oversight of the service and developing a more open culture. The management team was implementing best practice and poor practice was being challenged. Although this had been an unsettled period, the improvements, such as the new style quality checks, were enhancing people’s quality of life.

There were effective systems to keep people safe which adapted to their specific needs. Staff knew how to look after people safely and managed risk well. They provided excellent support to help people take their medicines safely, in line with best practice.

There were enough safely recruited staff to keep people safe. Families and staff told us they did not like agency staff being used as they did not know people as well as permanent staff. The provider tried to avoid using agency staff but was having to do so in some areas where recruitment was a challenge. They were was actively recruiting more permanent staff.

The provider was continually adapting training and learning systems to ensure staff had the necessary skills to meet peoples’ needs. Staff worked well with people, families and outside agencies to promote people’s wellbeing and health. Care plans were being revised, and the new style of plan was highly person centred and an example of best practice.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible in their best interests. Policies and systems in the service supported this practice, though improvements in this area were ongoing.

Staff knew people well and developed positive respectful relationships with them. People’s independence and right to determine the support they received was promoted throughout the service. Throughout the organisation people were communicated with effectively and in a personalised manner.

People were supported to be active and develop their interests. 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 24 February 2017). Since this rating was awarded the provider had restructured and the registration had been updated. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Why we inspected

This was a scheduled inspection based on the rating at the last inspection.

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.