Archived: Thomas Place

Updated 18 October 2018

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 5, 6 and 7 September 2018 and was announced. We gave the service short notice of our inspection to ensure that people using the service could decide if they wished to receive a visit or a telephone call from us and to ensure we had the correct contact details for people and their relatives.

The inspection was carried out by one inspector and one expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Inspection site visit activity started on 5 September and ended on 7 September 2018. On 5 September, we visited the office to review the documents associated with the running of the service and we visited people that used the service. On the 6 and 7 September, we made telephone calls to people, their relatives and external health and social care representatives to gain their feedback on the service.

Before the inspection took place, we looked at information we held about the service including registration information and statutory notifications. Statutory notifications include information about important events which the provider is required to send us by law. On this occasion we did not ask the provider to send us a provider information return (PIR). This is information we ask providers to send us at least once annually to give us some key information about the service, what the service does well and improvements they plan to make. However, we offered the provider the opportunity to share information with us that they felt was relevant, during and following the inspection process.

During our inspection we spoke with the care delivery director, field care supervisor and three care staff. We spoke with eight people who used the service and three relatives. We looked at a range of documents and written records including three people's care records, three staff recruitment records and information relating to staff training and the auditing and monitoring of service provision.

Following our inspection, we spoke with the manager of the service via telephone and we gathered further feedback about the service from health and social care professionals who worked closely with the service.

Updated 18 October 2018

The inspection took place on the 5, 6 and 7 September 2018 and was announced.

Thomas Place provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

Not everyone using Thomas Place receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection, there were 25 people receiving the regulated activity.

This was the first inspection of the service since their registration with the CQC on 14 November 2017, following a change in provider. The service’s office was based at the site of the extra care unit.

There was no registered manager working at the service. 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 and associated Regulations about how the service is run. We were supported during the inspection by the care delivery director and the field care supervisor. The provider had employed a manager who had started working at the service in June 2018. At the time of our inspection, they had not started the process of applying to be the registered manager with the Care Quality Commission. The provider was in breach of their registration by not having a registered manager in post.

People told us they felt safe living at Thomas Place. People were protected from the risk of abuse, staff had received training and were knowledgeable about what do to in the event of a safeguarding concern being raised. The manager had notified the local authority of safeguarding concerns but they had failed to submit notification to CQC.

On the day of the inspection, we observed and people we spoke with told us there were sufficient numbers of staff deployed to support them. However, following the inspection, we received mixed feedback from people and key professionals involved with the service. People told us staff were often rushing and they did not always know who was coming to provide them with support. Key professionals told us people often reported late calls.

We have made a recommendation about this in the report.

Staff knew and understood their roles and responsibilities. Staff had received training relevant to their roles and received regular updates. Staff were supported through planned one to one supervisions to discuss their training and development. Staff meetings gave staff the opportunity to voice their opinions. The provider’s policies and systems promoted safe recruitment practices.

Where required, people were supported to manage and take their medicines as prescribed. Staff received training in medicines administration and had access to the provider’s policy for further guidance. Competency checks were routinely carried out by senior staff.

People's needs were assessed before they started using the service and support plans were person centred.

Risks to people were assessed, monitored and were reviewed regularly or when people's needs changed. People were involved in decisions about any risks they may take.

People were treated with kindness, respect and compassion. Staff respected people’s privacy when supporting them.

People were supported to maintain good health and were referred to healthcare professionals when this was required.

People were protected from the risk of poor nutrition and staff were aware of people's nutritional needs. The service worked with external professionals, such as district nurses, GPs, occupational therapists and speech and language therapists as and when needed.

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 who used the service and their relatives were aware of how to make a complaint. Complaints were recorded, investigated and responded to in line with the provider’s policy.

People, relatives and staff were consulted about the quality of the service. People told us management and staff were helpful and approachable.

People were protected by the prevention and control of infection; staff had access to personal protective equipment and completed food hygiene training.

There were quality assurance systems in place, which were used to promote continuous improvement. Accidents and incidents were reported and analysed to identify any patterns or trends to help reduce the likelihood of the incident or accident happening again.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of section 33 of the Health and Social Care Act 2008. You can see what action we told the provider to take at the back of the full version of the report.