The inspection of Thorpe House took place on 12 August 2016 and was unannounced. We interviewed the registered manager on 19 August 2016 as they were unavailable on the day of our inspection. The service was last inspected on 17 October 2013 and met the Health and Social Care Act 2008 Regulations in operation at that time.

Thorpe House Specialist Adult Mental Health Unit Limited is registered to provide accommodation/nursing care for people with mental health problems. The service is registered for 23 people. There were 20 people living there on the day of our inspection.

The service had a registered manager in post who had been registered since 2011. 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.’

Staff had received training in how to keep people safe. All the staff we spoke with demonstrated they understood how to ensure people were safeguarded against abuse and they knew the procedure to follow to report any incidents.

The service had a positive approach to risk. They assessed how people could be supported to live the life they wanted and worked with people in an enabling way when independent living had been identified as an achievable goal. They encouraged people to identify and manage their own risks.

We found the environment to be maintained to a high standard and was extremely clean with good infection control practices in place. Staff were observed to follow good practice guidelines in the management and prevention of infections.

Staffing levels were determined to support people well with their physical, social and emotional needs. They worked an on call system to ensure when people’s needs changed at short notice; there were always staff on hand to assist. The service recognised the potential of a multi-disciplinary approach and the benefits this brought to the people using the service and the staffing complement included registered mental nurses, nursing assistants and occupational therapists.

The registered manager understood their obligations under the Mental Capacity Act 2005 and Mental Health Act 1983 and worked within the legislative frameworks. Staff had received training and were fully informed of any changes at team meetings to ensure they continued to provide care within the law.

People received care and support from a highly trained, motivated group of staff. Staff received an induction and training to ensure they had the skills to meet the needs of the people at Thorpe House. Staff were supported to continually develop by obtaining nationally recognised qualifications and by on-going supervision and appraisal. They were keen to develop new skills to provide the best level of support to people.

People told us how much they enjoyed their meals and they were given appropriate and sensitive support by care staff. People told us they were offered choice about what they wanted to eat, where they wanted to eat and at what time they wanted to eat, demonstrating the service was flexible in its approach.

Staff were responsive to people’s individual needs, preferences and wishes and were passionate about providing a high standard of care and support. The service was inclusive when plans were being drawn up to ensure outcomes were achieved.

Without exception, people, their relatives and professionals told us they were very happy with the caring approach and attitude of the staff team who they described as kind and friendly. We observed caring relationships had been built between staff and people using the service and some people told us they considered staff as friends.

We observed staff knocked on doors before entering people’s rooms, demonstrating staff respected people’s need for privacy. Confidentiality was r

We spoke with two people who lived at the home and they both told us they were happy at the home and that they felt safe. They also told us the staff were very nice and they enjoyed the activities at the home. We also spoke with the relatives of another person and they told us "We can't say enough good things about the place. We are always kept up to date with how our relative is doing. We are really happy with the care out relative receives and think the number of qualified staff on duty here is really reassuring. We give it ten out of ten".

People who lived at the home told us they were comfortable and felt safe in their surroundings. They all told us that the staff cared for them well, they were kind and they were able to talk to staff about any concerns or worries. We saw there were a range of activities on offer and at the time of our visit three people were going out for lunch into the local community.

We carried out a visit to Thorpe House Nursing Home on 20 September 2011 to follow up compliance and improvement actions made following the last review of compliance at Thorpe House in August 2011. Because we needed specific information from the management of the home to demonstrate their compliance with the essential standards, we did not need to speak directly with people who live at the home.

People told us that they are involved in decision-making about their care. They also said they have choices about how they live their daily lives and feel that their views are listened to.

People told us that they like living at the home. One person commented “The care could not be better. My privacy is always maintained and when needing any kind of support I have never felt embarrassed”. Another person said, “They do things properly”.

A person told us about their physical health problems and said, “If it was not for the staff I would not be here today”. Another comment was “I am looked after very well. If I misbehave staff keep me in check”. One person did say that people are strongly encouraged to go out for a walk with staff in a morning.

People who were spoken to all said that they felt safe at the home.

People told us that there are always enough staff about to support them and to assist them when going out if this was needed.

People said that staff were supportive and knew what they were doing.

People said that they felt involved in decisions about how the home was run and completed surveys to express their views about the care and services on offer.