CQC report explained · a residential care home
What the CQC found at Thornbury Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found enough staff, safe recruitment, suitable risk assessments, safe medicine systems and effective infection control, although some safety checks had not been recorded.
- Effective?
- Good
- This key question was not inspected in this visit. Its rating was carried forward from the previous inspection.
- Caring?
- Good
- This key question was not inspected in this visit. Its rating was carried forward from the previous inspection.
- Responsive?
- Good
- This key question was not inspected in this visit. Its rating was carried forward from the previous inspection.
- Well-led?
- Requires improvement
- The home had an open and positive culture, and people and staff felt listened to. However, its quality checks did not always identify missing records, missing medicine protocols or a care plan that needed updating.
What inspectors found, November 2023
Rated Good; inspectors found safe, kind care, but the home’s quality checks did not always identify problems.
This was an unannounced inspection on 17 and 18 October 2023. Two inspectors spoke with 15 people, one relative and five staff. They reviewed care records, medicine records, staff files and management records.
The home was rated Good overall and Good for Safe. Inspectors found enough staff, safe recruitment, clean surroundings, suitable risk assessments and safe medicine handling. People said they felt safe and well cared for.
Well-led was rated Requires Improvement, as the home’s checks had not found some shortfalls. These included missing records of water temperature checks, missing instructions for some as-required medicines and one care plan that needed updating. These issues were dealt with during the inspection.
The overall rating stayed Good, as the other key question ratings were carried forward from the previous inspection. The previous overall rating was Good, published on 29 November 2017.
Enough staff
Inspectors found staffing levels were stable and suitable for people’s needs. People received care in an unrushed and personalised way.
“There were enough staff to meet people's needs.” from the report
Safe care planning
People had individual care plans and risk assessments. These covered areas such as falls, nutrition, weight and skin care.
“The care plans had individual risk assessments which guided staff in providing safe care.” from the report
People had a voice
People, relatives and staff could give feedback and raise concerns. Inspectors found that feedback was listened to and used to make changes.
“People and their relatives felt able to raise any concerns they had and were confident they would receive an appropriate response.” from the report
Open culture
Inspectors found that the management team was approachable and that staff felt supported to share ideas and discuss problems.
“There was a positive and open culture at the service.” from the report
Quality checks missed problems
needs fixingThe home’s governance checks did not identify all the shortfalls found by inspectors. This is why Well-led remained Requires Improvement.
“The provider's governance system did not always effectively monitor the quality of care provided to drive improvements.” from the report
Medicine instructions were missing
needs fixingInstructions for some as-required medicines had not been transferred to the new medicine records. The home put them in place during the inspection and inspectors found no impact on people’s health.
“Protocols which described the circumstances and symptoms of when the person may have needed this medicine were not in place.” from the report
Some safety records were missing
minorWater temperature checks had been carried out but were not recorded in the file. The checks were completed again during the inspection and no problems were found.
“The hot water temperatures were not available to view but we were assured they had been undertaken but not recorded in the file.” from the report
One care plan needed updating
needs fixingOne person’s care plan had not been updated after their health deteriorated. It was updated during the inspection, and inspectors found no impact on the person’s health or wellbeing.
“there were areas for one person that had not be updated as a persons' health had deteriorated” from the report
- 01How do you now check that as-required medicine protocols are transferred correctly when the medicine provider changes?
- 02How often are hot water temperatures checked, and where are the results recorded?
- 03How do you make sure care plans are updated promptly when someone’s health changes?
- 04What changes have you made to your quality assurance checks since this inspection?
- 05How can residents and relatives see what action has been taken after feedback or complaints?
This was an unannounced inspection of Safe and Well-led only; the Effective, Caring and Responsive ratings were carried forward from the previous inspection. This explanation was written from the published report of 16 November 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, November 2017
Rated Good overall; inspectors found safe, kind and personalised care, but the home’s leadership and quality checks still needed improvement.
Inspectors made an unannounced, comprehensive visit on 23 October 2017. They spoke with people, staff, relatives and visitors, observed care and mealtimes, and checked care records, medicines, staff files and management records.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found enough staff, safe medicines practice, suitable training, good support with food and healthcare, respect for people's choices, and activities based on people's preferences.
The home was rated Requires Improvement for Well-led. Quality systems had improved and earlier legal breaches had been met, but some audits and records of improvement were not yet consistent. The overall rating was Good.
Safe care
Inspectors found that risks were assessed and managed, medicines were handled safely and staffing was sufficient.
“There were sufficient numbers of suitably trained staff to keep people safe and meet their individual needs.” from the report
Kind and respectful staff
People were treated with dignity and staff respected their choices, privacy and independence.
“When people needed assistance staff asked them quietly and discretely if they could assist them and waited for a response before they did so.” from the report
Personalised support
Care plans were individual and were updated to reflect people's changing needs and preferences.
“Care plans had continued to be improved and provided clear detailed guidance for staff.” from the report
Food and healthcare
People had meal choices, support with special diets and access to health and social care professionals when needed.
“People were supported to have a nutritious diet and sufficient drinks to meet their needs.” from the report
Quality checks were not fully embedded
needs fixingSome audits did not yet cover all areas of care delivery and actions taken to improve the service were not always recorded.
“Quality assurance systems were in place. However some audits needed further development to ensure they covered all areas of care delivery and support.” from the report
Activities and trips
minorSome people said there were fewer trips and entertainers than before. Inspectors said activities and opportunities for trips out were not as good as they used to be.
“Feedback from people during the inspection told us that they felt activities and opportunities for trips out were not as good as they used to be.” from the report
Visual impairment and the environment
needs fixingThe home needed to improve support for visual impairment and had not fully considered how one person's impairment affected access to food. A communal television was also not working.
“Improvements in respect of how staff can support people with visual impairment was required such as specialist lighting and large print in house information.” from the report
- 01How are your quality audits carried out now, and how do you record and check that actions have been completed?
- 02What activities and trips out are currently available, and how do residents help decide them?
- 03What specialist lighting, large-print information or other support is available for people with visual impairment?
- 04Has the communal television been repaired, and how are equipment problems reported and followed up?
- 05How do you check that care plans reflect the position of furniture and equipment where this could cause trips or falls?
This was an unannounced comprehensive inspection covering all five key questions and setting ratings for the whole service. This explanation was written from the published report of 29 November 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Thornbury Residential Home
4 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- November 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2017Goodup from Requires improvementSafe: GoodWell-led: Requires improvement
- August 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- December 2014
Report published without a new overall rating.
- October 2014
Report published without a new overall rating.
- July 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 26 November 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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