Membership review for Options Thorpe House
By – Date of visit:
The membership review is intended to reflect the experiences of the visitor who might be looking for a placement.
The review is subjective, consistent and impartial, representing the impressions of our team member on the day of the visit. It is a snapshot view only. The contents of this review are intended to cover some of the subjects and issues which an individual, their relatives or their placement officer might ask.
This review has been published with the written agreement of the home owner, or an authorised representative of the company.
‘Staff were very proud of the achievements made by individuals since they had arrived at Thorpe and described the excellent progress they had made.’
Summary of findings
On the day of the visit, Thorpe House came across as a warm, friendly home providing a high level of care for adults on the autism spectrum with a diverse range of needs. The living accommodation was of a really high standard coupled with an apparently dedicated and highly motivated staff team. The service was seen to be meeting the needs of a diverse group of individuals who had also benefitted from a lot of input from the Professional and Clinical Multidisciplinary Team which comprises of a Clinical Psychologist, Assistant Psychologist and Speech and Language Therapist based a mile away at Roxby House. Staff were very proud of the achievements made by individuals since they had arrived at Thorpe and described the excellent progress they had made.
Introduction
Thorpe House is an eleven-bedded residential home for adults with autism and additional needs between the ages of 16 and 65. The home is set in large grounds on the A1077 just outside Scunthorpe. On the day of the visit there were individuals with quite a range of needs residing at Thorpe House from higher functioning autism to severe autism with accompanying learning difficulties and conditions such as Prader Willi syndrome, epilepsy and bipolar disorder. Thorpe was visited by the Care Quality Commission in April 2013 and was seen to be compliant in the following areas with no requirements -
- Standards of treating people with respect and involving them in their care
- Standards of providing care, treatment & support which meets people's needs
- Standards of caring for people safely & protecting them from harm
- Standards of staffing
- Standards of management
First impressions
I rang the bell at the gate and within a short space of time a staff member arrived to take me through to the reception. The reception actually doubles up as the main office. Staff were friendly and I recognised familiar faces from previous visits. I was asked to sign in and then I was immediately offered a drink before being taken through to the Registered Manager’s office.
The Environment (External)
Thorpe House is enclosed by fencing around the site. This enclosure, however, does not feel at all oppressive. On the day I visited, due to the complexities of individual’s needs, no-one residing at Thorpe could venture out without the support of a member of staff.
Although the A1077 is a fairly busy road, once inside the building you can barely hear any noise from the traffic. Lighting is fitted to the exterior of the building and the exterior can be well illuminated during hours of darkness and this includes the car parking area. There are seating areas in the grounds as well as two purpose-built outdoor buildings one of which houses an art and music room with an adjoining Snoezelen. I was told that the tarmacked area adjacent to the main building was to be developed into a playground area with swings and roundabout. There were also plans for a wild garden to the rear of the main building. Traditional planting had not always worked previously as a couple of individuals had targeted plants and pulled them up.
The Environment (Internal)
When I visited two years ago the internal environment had undergone and was undergoing further changes. On this visit the reconstruction work was found to be complete. The accommodation was divided into 5 individual flatlets on the ground floor and two areas on the first floor which have three rooms in one section and three in another, although within this second group one of the rooms is essentially a separate flat. All in all, this layout is a flexible arrangement which could be adapted to suit the individual needs of the client group. The arrangements had meant that individuals could spend more time on their own and mix with other people at times of their choosing. Staff reported quite a significant reduction of incidents of anxiety since these arrangements have been in place.
The Environment (Wider Environment)
As previously mentioned there is a busy road running parallel to Thorpe House. This does mean that accessing local transport is easy as buses run regularly from a nearby bus stop into Scunthorpe. This service is only accessed by some individuals. A new scheme in the Scunthorpe area allows staff members to accompany the individual they were supporting to travel free on local buses.
On the day of the visit one young person living at Thorpe had a motability vehicle and there were also two seven-seater people carriers available. Staff have to undergo a driving assessment before they can begin using the vehicles.
Several individuals spend time over at nearby Roxby House, an Options Group facility, engaging in both vocational and leisure pursuits.
Understanding Autism
Thorpe House is an autism-specific placement and as such the level of focus on autism is strong, although many of the individuals at Thorpe have complex additional needs including Prader Willi Syndrome, Bipolar Disorder and epilepsy.
Autism training is at the core of staff induction and training is very much continual. On occasion, anxiety levels of individuals can lead to outbursts which may require staff to physically intervene for the person’s own safety. The Options Group have developed along with PRICE (Protecting Rights In a Caring Environment) a bespoke autism intervention package which all staff are trained to use safely.
In terms of communication, protocols are developed with each individual to suit their strengths. Some individuals can use symbol-based communication, but for others this is too complex and simple pictorial objects of reference are used. There is significant input from Options’ own Speech and Language therapist in developing systems and individual communication profiles. Each individual also has a sensory profile which, again, is developed with Options’ own Professional and Clinical Multidisciplinary Team based just a mile away at Roxby House.
Preparation for both admission and transition seemed very thorough. Rebecca (Registered Manager) is accompanied by a member of staff from the Professional and Clinical Multidisciplinary Team during any assessment visit.
Those individuals who are able to engage effectively and can express their views are encouraged to present their views at regular meetings. Individuals who are unable to engage in such a way have their ‘Keyworkers’ advocate for them on their behalf.
Each individual has a daily activity programme which takes into account their needs, potential and need for structure. Individuals have their ‘timetable’ documented in different forms in a medium that suited their overall communication profile. Individuals were being encouraged to express their likes and dislikes, as well as their wants and needs in whatever medium was comfortable for them. One individual liked to write a list, for instance, and to tick things off as each thing had been achieved.
Health and Wellbeing
Every effort is made to ensure each individual living at Thorpe House receives a balanced diet. Two selections are offered to each person at meal times. Some individuals cannot express their wishes and tastes effectively and rely on their Keyworker to make informed decisions on their behalf. Rebecca mentioned that several staff had been due to undertake a diet and nutrition course, however, it had been cancelled and alternatives were being sourced. One person living at Thorpe has Prader Willi syndrome, so particular measures had been put in place to manage the individual’s condition. No-one living at Thorpe House self-medicated on the day of the visit.
Each individual has their own health and wellbeing file which is split into several sections. All people at Thorpe are accompanied to regular doctor and dental appointments. A lot of work is undertaken with individuals prior to these visits to reduce anxiety as much as possible.
Individuals living in the home
When I visited, eleven people were residing at Thorpe. All had an autism diagnosis, but their abilities and complexity of needs were wide and varied. Several individuals had idiosyncratic sensory needs and staff talked about how these needs were met at Thorpe, not only in terms of the environment, but also in terms of clothing, diet and of construction of daily activity programmes. Each person’s daily programme also reflects their abilities, interests and capabilities. Staff mentioned that there were core activities most individuals enjoyed and gained a lot from; these were bowling, horse riding, swimming and ‘Play-zone’.
Communication needs are also quite varied. Each individual is communicated with in a way they are comfortable with and this includes use of technology like iPads.
Two people living at Thorpe were managing their finances to some extent with varying degrees of support, but the other individuals again relied on staff advocating for them.
Rebecca (Registered Manager) spoke about a couple of individuals who were being supported to maintain their religious faith.
Staffing
The staff team comprised of a number of individuals who were working at Thorpe when I visited two years ago and Rebecca confirmed that staff turnover on the whole was low.
No staff members are allowed to work until they have completed a Disclosure and Barring Service check. The induction period for staff members is thorough and autism focused and, again, until this has been completed, no staff member is allowed to work with any individual living at Thorpe House.
All staff members are issued with a handbook at the beginning of their roles which includes details around expected conduct and appropriate clothing amongst other guidelines.
Staff members have regular supervisions with a staff member senior to them to assess their work and set targets for the future. Supervisions are undertaken every two months as a minimum, once a month for the first six months of service. Supervisions had received an overhaul in terms of methodology to ensure the sessions offer individuals practical support.
All members of staff working at Thorpe are trained in the use of PRICE (Protecting Rights In a Caring Environment) which can ultimately involve physical intervention to prevent individuals harming themselves or others.
Management of the home
Policies and procedures relating to the running of the home are located in the main office and are easily accessible for staff when required, they are also available on the Options Group portal.
Rebecca spoke about the arrangements of staff on a day-to-day basis and how successful having workers who did overlapping shifts had been, bringing in more togetherness and taking away unhealthy competition between shifts.
When asked what made Thorpe House a unique and special service Rebecca mentioned several factors - ‘a dedicated staff team with a proven track record of managing and developing individuals with very complex needs.’ She also felt the team was very inclusive and used the example of ‘focus meetings’ which allowed all staff members to comment and put forward ideas regarding the care of specific individuals. In the next two years Rebecca’s key aims are to build on what is already proving successful and to develop the outside space at Thorpe more fully with a play area and garden fully developed.
There is a system in place for debriefing staff after stressful incidents. Individual debriefs are also available; these are carried out by senior members of staff who were not involved in the incident or issue.
Rebecca (Registered Manager) spoke of the staff team in terms of their ability to help support the individuals with their families; this ranged from simple facilitation of communication to actual hands-on support and advice in the family home when necessary.
Conclusion
Thorpe House was providing an excellent environment for the individuals residing there with a supportive staff team backed by clinical expertise close at hand. The staff team seemed enthusiastic and from the short time I was there I noticed that staff engaged with individuals well, striking the right balance between offering encouragement and allowing choice. The service was seen to be meeting the needs of a group of individuals who, as well as the diagnosis of autism, had other complex needs. A place at Thorpe was becoming available in February and I would have no hesitation in recommending the home as an excellent place for an individual on the autistic spectrum needing a high level of support.
Visiting Officer: Craig Godding
Director of Operations, Living Autism