Thorndene

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People told us they felt safe and secure with the support they received. Staff understood how to identify and report concerns. The service and people’s equipment were well maintained and kept clean. Where people where deprived of their liberty the appropriate authorisation to do so had been sought. There was enough staff to provide people with support. Staff were well trained and supported and understood people’s needs. People were involved in making decisions about risk. Staff understood the risks people face and how to support people to remain safe. Staff worked with people to make decisions about how risks were managed day to day.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us they felt safe, and staff knew how to protect them from risks. One person said, “I feel very safe here because I have nice people around me.” Relatives were also positive about safety of the service. One relative said, “There is very high quality of care, and they have regular staff meetings and always keep in touch with us. I trust them with my own life, they are a super bunch of people.”

Staff demonstrated a good understanding of abuse and how to protect people from it. They knew who to contact if they suspected abuse was happening. Staff told us they had received safeguarding training and were reminded when this needed to be refreshed. Staff and residents routinely discussed what safeguarding was and how to report it at every meeting. Staff told us, “Safeguarding is always top of the agenda at all our resident’s meetings.”

The home had a pleasant aroma, was light, clean and homely. People were relaxed in the company of staff. Staff engaged with people in a polite way and were positive and respectful. Staff provided encouragement and reassurance when people needed this. The equipment people used was well maintained and clean to ensure it was safe for people to use.

There were clear safeguarding and whistleblowing policies and processes which staff understood. Staff were required to undertake safeguarding training annually and this was monitored. When incidents happened, they were investigated, reported to the local authority and CQC were informed when appropriate. Incidents and accidents were reviewed to identify any potential patterns, such as behaviour changes or a deterioration in health. This enabled external health care professionals to be contacted for further advice as and when required. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. People can only be deprived of their liberty when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). In supported living settings this was usually arranged through the court of protection. There were effective systems in place to ensure authorisation had been sought where people were deprived of their liberty.

People felt involved in their care and that they were supported to take positive risks to enable them to live the life they chose. One person said, “They ask me what I want to do, and we take it from there.” Staff discussed risks and safety with people, for example what to do if the fire alarm sounded. One person told us, “When the alarm goes off, I know what to do and where to go.” One relative told us, “[Staff] know [my relatives] structure and they respect [their] wishes, and they are very quick to let us know if there is any change in [their] needs

Staff understood the risks to people and supported people to be as safe as possible without impinging people’s rights and freedoms. One staff told us, “We want our residents to be as self-managing as possible, which will mean we need to discuss the risks and if they outweigh the positives.” Staff said, “We risk assess as we go – if [a person wanted to participate in a new activity], we facilitate that as far as possible and talk through the risks with them.” Staff knew the signs and symptoms of people becoming unwell and knew how to support people to remain as safe as possible whilst respecting people’s choices and rights.

We observed people were engaged in a wide range of activities and hobbies and had associated risk assessments as part of their care plans. Where people needed one to one or two to one support this was in place. People chose and prepared their own meals and drinks and enjoyed doing so. Staff were caring, listening to, and respecting people’s personal choices throughout the day.

There was guidance for staff on people’s risks and how to provide support for those risks. For example, where people had epilepsy there was information on what their seizures looked like, and how they impacted people. There was guidance for staff on how to support the person during and after a seizure. Where people had emergency medicines in place there was clear guidance on when to use this and staff had received appropriate training.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us there were enough staff and they always had the staff ratio they needed throughout the day and nighttime. Support was given by the same staff team, so people knew the staff who were supporting them very well and vice-versa. One person told us, “[Staff] give me lots of time when I need it, like when I can’t speak words very well.” One relative told us, “I visit regularly because there is a welcome, open-door policy to visiting and there has always been plenty of staff around.”

Staff told us there were enough staff to support people safely. Staff told us the training was sufficient for their role and were positive about recent face to face training. One staff said, “I have recently had Fire Marshall and First Aid training face to face, which was excellent.”

We observed there was enough staff to support people. Everyone was being supported one to one, staff presence was not intrusive and did not restrict people as they moved freely around the service and in the gardens and grounds. People and staff had a positive relationship with each other. The atmosphere within the home was calm and relaxed.

Staffing levels were based on people’s assessed needs which included people’s one to one and two to one support as well as any shared hours they were assessed as needing. There were systems in place to plan the rota to ensure people’s hours were met. Staff had the training they needed to provide support to people, this included a mixture of face to face and online learning. Training included areas such as safeguarding people, autism, epilepsy and positive behaviour support. Staff competency to undertake medicine administration had been checked as appropriate. Staff were provided with support and supervision. Appropriate checks were undertaken to ensure staff were recruited safety. For example, Disclosure and Barring service (DBS) checks were undertaken. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. New staff shadowed more experienced staff to learn about people and their needs prior to working alone.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.