Background to this inspection
Updated
18 March 2021
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.
As part of CQC’s response to the coronavirus pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.
This inspection took place on 3 March 2021 and was announced.
Updated
18 March 2021
This inspection was carried out on 27 September 2018 and was unannounced.
Thomas house is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection. The home is situated within the St Helens area. The home offers accommodation and support for up to 28 people. At the time of our visit there were 22 people living at Thomas house.
The home did not have a registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.
At the last inspection, the service was rated good.
The registered provider had policies and procedures in place that were regularly reviewed and updated. We identified some disparity of information relating to the complaints policy. The Statement of Purpose held out of date information including details of a previous regulator. The registered provider stated they would immediately review and update these documents to ensure they held the correct information.
The registered provider continued to have safe recruitment processes in place. All staff had completed an induction at the start of their employment and undertaken shadow shifts with an experienced member of staff. Mandatory training was consistently completed along with refresher training updates as required in accordance with good practice guidelines. Staff received regular support through supervision and team meetings.
The registered provider had safeguarding policies and procedures in place. Staff felt confident and knew what they needed to do if they had any concerns. Staff had received training and were able to describe what abuse may look like. They thought any concerns they had would be listened to.
People had their needs assessed before they moved into the home and this information was used to create individual care plans that included clear guidance for staff to follow to meet people’s needs. People’s needs that related to age, disability, religion or other protected characteristics were considered throughout the assessment and care planning process. Care plans were reviewed and updated regularly.
Staff had developed positive relationships with people living at the home. People told us they had support from regular staff that respected their privacy and promoted their independence where possible. We observed positive interactions between people and staff that supported them throughout our inspection. Staff were caring and demonstrated kindness and patience. People’s privacy and dignity was respected. A variety of activities were available for people to participate in.
Medicines were ordered, stored, administered and disposed of in accordance with best practice guidelines. The registered provider had medicine policies and procedures in place. Medicine administration records (MARs) were fully completed and regularly audited for accuracy. Staff that administered medicines had all received training and had their competency regularly assessed.
People were supported by staff with their food and drink needs. When people had been identified as having specific assessed dietary needs staff had guidance available to support this. People spoke positively about the food and drink.
Quality assurance systems were in place that were consistently completed. Areas for development and improvement had been identified and action taken to complete these. Accidents and incidents were analysed to identify trends and patterns within the home. Health and safety checks, equipment testing and servicing and fire checks were regularly undertaken within the home.
The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and report on what we find. We saw that the registered provider had guidance available for staff in relation to the MCA. Staff had undertaken training and demonstrated a basic understanding of this. The registered provider had made appropriate applications for the Deprivation of Liberty Safeguards (DoLS). Care records reviewed included mental capacity assessments and best interest meetings.
The registered provider had displayed their ratings from the previous inspection in line with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.