We inspected The Thicket on 23 June 2017 and the visit was unannounced. We spoke with relatives of people who used the service on 6 and 17 July. Our last inspection took place in February 2015 when we rated the service to be ‘Good’ in each of the five key topic areas with an overall rating of ‘Good.’The Thicket is a specialist residential care home for adults with learning disabilities and complex needs located on the outskirts of Otley. The service consists of four self-contained apartments. There are communal areas within the complex for people to enjoy activities and social events. There is also a sensory room, a spa room with hot tub and a large garden. At the time of our visit there were four people using the service.
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.
Robust systems and practices were in place to make sure people were safe within the ethos of positive risk taking for which detailed personal risk assessments were in place.
Safeguarding people was taken seriously and all staff were aware of how to recognise if people were at risk and what to do about it.
Systems for managing accidents and incidents were robust. All accidents and incidents were analysed at home and provider level to look at ways in which they could be avoided in the future and risks to people mitigated.
Medicines management was safe which helped ensure people received their medicines as prescribed.
Staff were recruited safely and told us their induction and shadowing was comprehensive and prepared them for their roles. We saw staff received the training and support they required to meet people’s needs. Training was based on best practice and guidance, so staff were provided with the most current information to support them in their work.
Staffing was arranged in line with the needs of the people who used the service. All people were supported on a one to one basis at all times with additional staff support for outings and activities.
Staff demonstrated a thorough knowledge of the Mental Capacity Act (MCA) and where deprivation of Liberty Safeguards (DoLS) were in place there was a commitment to least restrictive and best practice.
People had choice about their meals and were supported to be involved in shopping and preparation.
Staff actively supported people to make sure they received excellent levels of healthcare intervention and support to make sure they experienced optimum levels of physical and psychological well-being. People who used the service each had a care file dedicated to their health needs.
Staff consistently supported people to experience new things and were proactive and creative in the ways they did this to ensure people’s lives were fulfilled. A relative told us staff were “particularly good at looking at different ways of supporting (relative) always analysing what worked well and working to their strengths.
The service provided to people was extremely personalised and responsive and focussed on making people’s quality of life as good as possible and all staff were fully engaged in this process. Each person had an ‘All about me’ file which had been drawn up with them and provided a clear picture of everything about the person including their needs, wishes, fears and aspirations.
The service demonstrated a commitment to person centred care and concentrated on positive outcomes for people. People’s personal achievements were celebrated.
A relative we spoke with told us “They put (name) at the centre of everything they do”.
Each person had an ‘All about me’ and a ‘How to support me’ file which clearly outlined the support people needed not just in their daily lives but also to fulfil their dreams and aspirations.
People were supported to engage in meaningful activities and staff supported and encouraged people in making choices about the activities they experienced.
Systems were in place for people to raise any concerns or complaints they had about the service. A relative told us “Management are very responsive to any questions or concerns we have, it’s a two way thing. We are delighted with the place.”
All of the staff we spoke with demonstrated that the vision and values of the service are to enable people to live their lives at their optimum level through a person centred approach where positive risk taking is promoted.
Management systems were in place to put people at the heart of the service with opportunities for all people involved to voice their opinions and suggestions.