Sinon House Therapeutic Unit

Updated 4 February 2022

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Sinon House Therapeutic Unit is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

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.

Notice of inspection

This inspection was unannounced.

What we did before the inspection here

We sought and received feedback from the commissioners of the service and one young people social workers. We reviewed information we had received about the service since the last inspection. 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. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with the registered manager and one young person.

We reviewed a range of records. This included two young people’s risks assessments and medicines records. We looked at recruitment records of three staff, staff training, supervision and staff rotas. A variety of records relating to the management of the service were reviewed including accidents and incidents and audits.

After the inspection

We continued to seek clarification from the provider to validate evidence found. The provider sent us the staff training matrix, infection control procedures, medicines and incidents audits, progress reports for all three young people for November 2021 and information about the matching process of young people as requested in a timely manner. A matching process is used to ensure that young people who move to the service are compatible with those young people who already live there.

We telephoned the family members of each young person to gain feedback about young people’s experiences of using the service. We also received feedback from two young people’s social workers and telephoned three support staff.

Updated 4 February 2022

Sinon House Therapeutic Unit is a residential care home providing personal care for up to three people with complex needs. This can include a combination of a learning disability, autistic spectrum disorder, mental health difficulties an eating disorder and behaviours which challenge the person and/or other people. At the time of the inspection, three young people aged between 16 and 18 were being supported during their transition into adulthood.

Accommodation was provided over three floors. There were two communal lounges and a small garden and utility room to the back of the care home.

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

Young people told us they liked the staff that supported them. We observed young people were relaxed and at ease in staff's company.

Quality monitoring systems were inconsistent to be able to identify shortfalls and drive continuous improvement in the service. We found concerns with fire safety, incidents, and clinical support for assistant psychologists.

We signposted the provider to infection control guidance to be assured they were making sure infection outbreaks could be effectively prevented or managed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service support best practice.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• The model of care maximised people’s choice, control and independence. Young people views were actively sought and acted on and they were involved in planning their care.

Right care:

• Care was person-centred and promoted people’s dignity, privacy and human rights. Everyone told us that young people were treated with dignity and respect.

Right culture:

• The ethos, values, attitudes and behaviours of leaders and care staff ensured people using services lead confident, inclusive and empowered lives. Although there was a high turnover of staff at the service, the registered manager led by example and provided a positive environment for young people and staff.

Young people benefitted from the positive culture at the service. The registered manager was open, approachable and listened and responded to young people and staff. Family members described the registered manager as, “Fantastic”, “Really positive” and “Amazing” in the support they gave to young people.

Assessment of risk include clear guidance for staff on how to keep young people safe. Staff understood how to follow safeguarding policies and procedures to help keep young people safe.

Young people's health and well-being was monitored, and liaison took place with a range of health and social care professionals to support this. Staff understood there were challenges in supporting young people to eat healthy. Young people received the support they needed with their medicines.

Young people were treated well and with dignity and respect which had a positive impact on their well-being. Family members told us staff had developed positive relationships with young people. One family member told us, “I said to X (young person) I really think you are in the best place you could be, and X responded that they agreed”.

The service was responsive to young people’s needs. Young people had opportunities to go out and take part in things they were interested in.

Staff were checked that they were suitable to work with young people before they started to support people. There were enough trained staff available, so people received support when they needed it. The staff team felt well supported and listened to by other team members and the registered manager.

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

Rating at last inspection and update

The last rating for this service was Good (published 2 May 2019). The rating at this inspection has changed to Requires Improvement.

Why we inspected

The inspection was prompted in part due to concerns received about keeping young people safe and the overall management of the service. A decision was made for us to inspect and examine those risks and undertake a comprehensive inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

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.