We carried out this inspection on 18 & 20 May 2016 and the inspection was unannounced.

Thanet House is a care home registered to provide care and support for up to six adults with mental health needs. At the time of the inspection there were six people living at the service.

The service did not have a registered manager in place. At the time of the inspection the manager had applied to be registered with the commission. 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.

The service did not have adequate audits in place to effectively manage medicine stock. Audits carried out by staff did not always tally with the amount of medicines available in stock. Staff calculations of medicines remaining was incorrect, this meant it was difficult to ascertain if the remaining medicines were correct and if people had received their medicines as prescribed. The manager was implementing a new auditing tool for medicines, which would quickly identify errors and minimise the risk to people.

The last inspection took place on 17 July 2014 and the service met all areas inspected.

The service had comprehensive systems in place to protect people from the risk of harm and abuse. Risk assessments were in place that identified risks to people and gave staff guidelines on how to manage those risks. Staff were aware of the different types of abuse and the appropriate steps to take in reporting suspected abuse. Staff had received safeguarding training.

People’s care plans were person centred and tailored to meet their needs. Staff received guidance on how to support people according to their preferences and needs. Care plans detailed people’s history, likes and dislikes, medical needs and support requirements. Care plans were regularly updated to reflect people’s changing needs. Where possible people were encouraged to develop their care plans and their input and views were listened to and respected.

People’s consent was sought prior to the delivery of care. People were encouraged to make decisions about the care they received and their choices were respected. The manager and staff were aware of the correct procedure should someone be unable to give their consent. People were not deprived of their liberty unlawfully. The manager and staff had sufficient knowledge of the Mental Capacity Act 2005 [MCA] and Deprivation of Liberty Safeguards [DoLS] and their responsibilities within the legal framework.

Staff encouraged people’s privacy and dignity and were aware of the importance of doing so. Staff were kind and compassionate towards people in their care and encouraged positive relationships. People were encouraged to raise their concerns and complaints. People knew how to make a complaint and the manager was able to demonstrate the appropriate system for dealing with complaints in a timely manner. The service had information in the communal area of the service on how to raise a complaint.

People had sufficient amounts of nutritional food to eat and drink. The service liaised with health care professionals to support them in devising a healthy menu that met people’s dietary requirements. People were encouraged to prepare their own meals when appropriate. People’s independence was encouraged and praised. Staff supported people to participate in a wide range of both in house and community based activities.

People were supported by sufficient numbers of skilled and knowledgeable staff. The service had robust recruitment procedures in place to ensure suitable staff were employed. Staff personnel files showed the provider had received checks from the Disclosure and Barring Service [DBS], two references and photo identification prior to staff starting work. Staff und

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

On the day of our inspection, people using the service did not wish to speak to us. However, we left our contact details if they wished to call us but did not receive any calls.

Is the service safe?

Staff were knowledgeable in recognising signs of potential abuse and the relevant reporting procedures.

Risk assessments were undertaken to identify risks to people who used the service and others. Management plans were in place to address the risks identified.

Is the service effective?

Assessments were undertaken to identify people’s support needs. Care plans were developed to identify how to meet people’s support needs, and identify goals and targets people wished to achieve whilst at the service.

Staff liaised with people’s care co-ordinator from the community mental health team to ensure people’s health, safety and welfare.

Is the service caring?

Staff were kind and caring. Staff were knowledgeable of people’s support needs and worked with people to achieve their goals. Staff supported people to attend appointments, and access the community where needed.

Is the service responsive to people’s needs?

People were involved in decisions about their care. Monthly meetings were held with staff to discuss people’s progress and identify any further support they required.

Is the service well-led?

There were processes in place to monitor the quality of service provision. The service had systems in place to obtain the views of people who used the service. Complaints were responded to appropriately and in a timely manner.

People using the service were happy with the service they received and appreciated the support provided by the staff.

Individual care plans were in place for people using the service which addressed their care and support needs. There were crisis and contingency plans in place to identify what to do if someone’s health deteriorated.

Staff at the service worked with care co-ordinators and consultant psychiatrists to ensure people’s health needs were being met.

People using the service told us they felt safe staying there. People were protected from the possibility of abuse as staff were able to demonstrate knowledge in recognising signs of abuse and knew the reporting procedures.

Staff were supported and were completing a Qualification and Credit Framework in understanding working in mental health in addition to attending mandatory training on health and safety, food hygiene and safeguarding. Staff received regular supervision and appraisals.

There were systems in place to monitor the quality of service provision. People using the service were able to comment on the service they received and felt their comments were listened to.

At the time of our inspection, Thanet House was providing support to five people. We spoke with two people who use the service and one staff member. We reviewed two care records.

People who use the service were well informed and involved in their care and treatment, and were happy to be at the service. One person told us, “I’ve landed on my feet.”

Care plans were comprehensive and focused on individual needs. People who use the service were involved in the development and review of their care plans.

Medicines were safely administered and there were clear arrangements for ordering, recording and disposing of medicines.

Staff told us they were well supported by their manager but there was no evidence of formal support structures in place.

The quality of service provision was monitored and learning from incidents and complaints was evidenced.

People enjoy the relaxed environment experienced at Thanet House. They said that it has helped them develop more social skills, and build on the relationships they have with fellow peers and staff.

One of the people that has experienced long term mental health related conditions said, “I have lived in a number of hostels and hospitals over the years, but I feel more at home here, I find the staff are supportive and non judgemental”.

A care coordinator told us that the home had enabled people experience positive outcomes, he found that people placed in this home had made progress. Another mental health professional spoke of the benefits to people in the home as a result of the structure received in their daily lives.