Thorndale

Thorndale is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Thorndale provides personal care for up to six people with a learning disability and/or autistic spectrum disorder. At the time of our inspection there were five people living at the home. The home is located next door to another of the provider's services, both of which are managed by the same registered manager and deputy manager.

A registered manager was in place at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

We last inspected this service on 3 September 2015 when it was rated 'Good' overall. During this inspection we found the service remained good and rated the key area of responsive as 'Outstanding.'

Relatives described the care at Thorndale as 'Outstanding.' Relatives told us how the service had made a huge impact on their family members by enabling them to lead full and rewarding lives and be as independent as possible. Staff did not view the complex needs of the people who used the service as a barrier to them participating in similar activities to those of their peers. Relatives told us people had access to a fantastic range of activities.

People had made substantial progress due to the use of the SMART (specific, measurable, achievable, realistic and timely) target system. These targets were a way of setting goals for people to work towards in areas that really mattered to them and which improved their quality of life. These targets and other positive proactive support strategies had resulted in a reduction in the number of incidents that could be challenging for people. The strong focus on person-centred care had an extremely positive impact on people.

People received care which was exceptionally person-centred and responsive to their needs. Staff had an excellent understanding of people's needs and how they preferred and needed to be supported. Staff were innovative at responding to changes in people's needs and identifying new support strategies for people.

Relatives told us they were very satisfied with the service and felt their family members were safe and happy at Thorndale.

Risk assessments about people's individual care needs were in place, for example in relation to nutrition and epilepsy. Control measures to minimise the risks identified were set out in people's care plans for staff to refer to. There was a positive approach to risk management.

Each person had an up to date personal emergency evacuation plan (PEEP) which provided staff with information about how to support them to evacuate the building in an emergency situation such as a fire or flood.

There were enough staff on duty to meet people's needs. Essential staff training was up to date. Staff received regular supervisions and appraisals.

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 were supported to have enough to eat and drink and attend appointments with healthcare professionals.

There were appropriate systems in place to record and respond to complaints. Relatives we spoke with said they had not needed to complain and felt any concerns would be dealt with correctly.

Relatives felt the service was well managed. Staff described the registered manager as approachable and the service as well-led. There was an effective quality assurance system in place to ensure the quality of the service and drive improvement.

There was a positive ethos at the service which was driven by the registered manager and deputy manager. Staff demonstrated a strong commitment to providing good care.

The five questions we ask about services and what we found