Thornbury Community Services

We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed autistic people and people with a learning disability respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.Following this assessment, the service was rated outstanding overall. We found people received safe, effective, caring, responsive and well-led support that was tailored to their individual needs and circumstances. Care plans were comprehensive, person-centred and regularly reviewed, reflecting people’s preferences, routines, communication needs and aspirations. Risk assessments were detailed and included clear guidance for staff on managing complex health conditions, environmental risks and emergency situations, enabling people to receive care safely within their own homes.

People’s health, wellbeing and communication needs were assessed and monitored, and staff worked closely with families and health and social care professionals to ensure care remained responsive to changing needs. We reviewed a range of records which demonstrated that care planning was personalised and involved people and, where appropriate, their relatives. Specialist care plans provided staff with clear instructions on supporting people with complex clinical needs, including ventilation, tracheostomy care, epilepsy management, enteral feeding, spinal injuries and mental health needs. Staff recognised changes in people’s health and knew when to seek advice or escalate concerns to ensure people received timely support.

People told us they felt supported and knew how to raise concerns. Most staff spoke positively about working for the service and described a culture focused on learning, teamwork and achieving positive outcomes. Staff received training, competency assessments, spot checks and supervision to support them in carrying out their roles safely and effectively. The service had robust recruitment processes, including checks on suitability, right to work and Disclosure and Barring Service (DBS) status. Staff were not permitted to work independently until they had demonstrated competence, and the service had systems to monitor training compliance and ongoing development. Staffing arrangements were planned around people’s assessed needs to promote continuity and consistency of care.

The service had effective systems and processes to monitor quality and safety. Leaders maintained oversight of incidents, complaints, audits, training and performance through a comprehensive governance framework. Leaders reviewed and investigated concerns, incidents and complaints. They identified learning and used them as an opportunity to drive improvement in the service. Leadership was visible and supportive, and staff described opportunities to contribute feedback and influence service development.

Overall, feedback about the service was positive. While some staff told us they would have welcomed additional support, this primarily related to opportunities for more regular communication and engagement with clinical leads and senior managers, as well as greater consistency in supervision arrangements. Most staff spoke positively about their experience of working for the service and described managers as approachable and support being available when needed.

No breaches of regulations were identified during this assessment. Overall, Thornbury Community Services demonstrated a positive, person-centred culture with strong leadership and governance arrangements that supported the delivery of safe, high-quality care and positive outcomes for people.