We inspected Theoc House on the 17 and 21 August 2018. Theoc House is registered to provide accommodation and personal care to 10 older people some who are living with an acquired brain injury. People are supported with their rehabilitation potential with the outcome to support them to move to more independent care and support such as supported living, or a home for life. The registered manager and provider shared a renewed focus on providing short term rehabilitation support for people as opposed to a care home for life.

At the time of our inspection, 10 people were receiving accommodation and support with their personal care and rehabilitation support. Theoc House is in Tewkesbury, Gloucestershire. The care home contains seven bedrooms, and two apartments (with one apartment housing two people). On the ground floor there is a dining room, kitchen, lounge and therapy room. People had access to a secure garden. Theoc House is located to a range of amenities and services. This was an unannounced inspection.

We previously inspected the home in August 2017 and rated the service as ‘Requires Improvement’. During our August 2017 inspection we found the provider was not always meeting all the required regulations. People did not always receive care and support which was personalised to their individual needs. The provider did not always ensure people’s care and rehabilitation records were current and accurate. There were not always systems in place to assess, monitor and improve the quality of care people received. At this inspection we found the provider and registered manager had ensured improvements had been made and the service was meeting all the required regulations.

We rated the service as ‘Good’ overall.

There was a registered manager in place at Theoc House. 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.

People were safe living at Theoc House. There were enough staff deployed to ensure people’s needs were being met. People received the support they required to meet their health and wellbeing needs. People were supported with their rehabilitation needs and plans were in place to support people to achieve their own personal goals and where appropriate move to more independent accommodation.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People received their medicines as prescribed. The risks associated with people’s care were managed well and people were supported to take positive risks and maintain their independence.

Support workers treated people with dignity and ensured their nutritional needs were met. Staff spoke positively about the support and communication they received. Support workers felt they had all the training and support they required to meet people’s needs.

People were supported to live their life to the fullest and enjoyed a wide range of activities and events. People benefitted from engagement and activities which were tailored to their individual needs and preferences. People were happy living at Theoc House.

Support workers were caring and were aware of people’s health needs. People and their relatives concerns and views were listened to and acted upon.

The registered manager and provider had systems to monitor and improve the quality of service people received at Theoc House. The registered manager, the deputy manager, the provider and support workers had a clear vision of how they wanted the service to develop and improve, with a focus on meeting people’s rehabilitation potential.

This inspection took place on 10 and 14 August 2017 and was unannounced. Theoc House provides accommodation, rehabilitation and personal care to up to 10 people who have an acquired brain injury. At the time of our inspection the service was fully occupied. Theoc House is based in Tewkesbury and is a short distance from a range of amenities. People were assisted by Support workers who assisted them with their day to day needs.

The service was rated ‘Good’ at our last inspection in December 2015. We found the provider was meeting all of the requirements of the regulations at that time; however we found that good practices had not always been established and maintained in relation to maintaining people’s care records and the monitoring of the quality of care being delivered.

People’s care records were not always current or reflective of their needs. The service did not always take opportunities to support people with promoting and developing their well-being needs, such as relationships with others.

There had been a recent change in management of Theoc House. Prior to these changes there was not always a clear and consistent record of audits being carried out. The provider had provided additional management support to Theoc House. There were detailed action plans in place to develop the service.

People told us they felt safe and comfortable living at Theoc House and they were in control of their care. People felt their needs were met by skilled and dedicated support workers. People were happy with the care and support they received. People received support which met their individual needs, such as personal hygiene, personal care, medicines and nutrition needs. People were supported to work towards individual goals.

Support workers spoke confidently about the support they received. They openly discussed the transition the service was going through. Support workers had the skills and training they needed to meet people’s needs. Support workers received support from the manager and their professional development was promoted.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what actions we told the provider to take at the back of the full version of this report.

This inspection took place on 2 December 2015 and was unannounced. Theoc House provides accommodation and rehabilitation care and support for up to ten who have an acquired brain injury. They service is located near the centre of Tewkesbury close to a range of local amenities. At the time of our inspection there were 9 people using this service.

The service had a registered manager. 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 and associated Regulations about how the service is run.

People told us they enjoyed living at the home. People were supported by kind, caring and compassionate care staff, who clearly knew people’s needs. Staff supported people to spend their days as they wished.

People were supported with activities, and enjoyed time spent with care staff and other people. People told us there were things for them to do in the home.

People told us they felt safe in the home, staff had a good understanding of safeguarding and the service took appropriate action to deal with any concerns or allegations of abuse.

People were protected from the risks associated with their care. Staff had clear guidance to protect people from risks such as smoking. Care workers took action to help maintain people’s independence.

There was a positive caring culture, promoted by the registered manager. Care workers were passionate about providing high quality personalised care and support. They spoke confidently and positively about people and their preferences. Care workers felt supported by the registered manager describing them as approachable and supportive both personally and professionally.

Care workers were knowledgeable about the people and carers they supported. They had access to development opportunities to improve their skills and the service people received. Care workers received the training they required to support people with individual needs and had access to effective supervision (one to one meetings with their manager).

People's needs were assessed. Where any risks were identified, management plans were in place. People were supported in a way that recognised their rights to take risks. The care and support people received was personalised to their needs. Care workers did not always record the support they provided people; however the registered manager had identified these concerns and was making appropriate changes.

Where people’s needs changed, care workers had taken action and made referrals to healthcare professionals where necessary. Care workers ensured people had care and support which met their needs and rehabilitation goals. Care workers went beyond their duties to support people with the things that were important to them.

People and their relatives view on the service were continuously sought. Care managers and the registered manager made every effort to ensure people’s views mattered. People and their carers felt the management was approachable and felt confident in their ability to complain.

Quality assurance systems were in place to enable the service to identify areas for improvement and ensure people received a good quality service. The registered manager was supported by a provider who carried out their own good governance audits. A recent audit showed the service was performing well. The service ensured people had the information they needed to make decisions and be involved in the day to day running of the home.