CQC report explained · a nursing home
What the CQC found at Thornfield Grange
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- This key question was not covered by the focused inspection. Its previous rating was used when calculating the overall rating.
- Effective?
- Good
- People had detailed, person-led assessments and were supported by trained staff. Staff supported people with communication, nutrition, healthcare and decision-making.
- Caring?
- Good
- People were treated with dignity, kindness and respect. Staff supported people to express their views, make choices and develop independence.
- Responsive?
- Good
- This key question was not covered by the focused inspection. Its previous rating was used when calculating the overall rating.
- Well-led?
- Good
- The home had improved its culture and teamwork. Managers used audits, feedback and partnership working to monitor quality and improve support.
What inspectors found, March 2023
Thornfield Grange rated Good; inspectors found respectful, person-centred support and major improvements since the last inspection.
This was an unannounced focused inspection. The inspector visited on 22 February 2023, spoke with people, relatives and staff, and reviewed care records, medicines records, recruitment files and management checks.
The home was rated Good for Effective, Caring and Well-led. Inspectors found that people were supported to make choices, build independence and access the community. Staff were described as skilled, caring and knowledgeable about individual needs.
The culture and environment had improved significantly since the previous inspection, which had found that improvement was needed. The overall rating changed from Requires Improvement to Good.
Independence and community access
People were supported to develop life skills, make choices and use the local community.
“People were actively encouraged to access the community and develop life skills and independence.” from the report
Skilled staff team
Inspectors found that teamwork had improved and staff were well trained and knowledgeable about the people they supported.
“At this visit we found teamwork had significantly improved and staff were well trained and knowledgeable about the people they were supporting.” from the report
Kind and respectful support
Staff showed empathy and understanding, and supported people with dignity, privacy and compassion.
“We observed sensitive interactions between people and staff who showed complete empathy and understanding when this was required along with sharing humour and fun.” from the report
Improved leadership
Managers had clearer oversight and the provider used audits and checks to monitor quality and safety.
“The provider had a robust system of audits and checks to monitor the quality and safety of the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you support my relative to access the community and develop life skills?
- 02How do you make sure staff understand and use my relative's communication and sensory needs?
- 03What training, supervision and support do staff receive before working with my relative?
- 04How will my relative and our family be involved in reviewing care and support?
- 05How do you use feedback, incidents and audits to make further improvements?
This was a focused inspection of Effective, Caring and Well-led; Safe and Responsive were not inspected, and their previous ratings were carried forward into the overall rating. This explanation was written from the published report of 10 March 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, July 2019
Rated Requires Improvement; inspectors found people were safe and supported, but dignity, the environment and some staff-support arrangements needed improvement.
This was an unannounced inspection after concerns were raised with the CQC. Two inspectors visited on 29 and 30 May 2019. They spoke with people, staff, relatives and professionals, observed daily activities, and checked care, medicines, staff and management records.
The home was rated Good for Safe, Responsive and Well-led. Inspectors found enough staff, safe medicines, suitable risk assessments, detailed care plans, activities in the community and effective quality checks.
The home was rated Requires Improvement for Effective and Caring. Inspectors found institutional language and displays that did not protect people's dignity or create a homely setting. Records of staff debriefs after incidents were not clear, and some relatives raised concerns about communication and staff consistency. The overall rating fell from Good at the previous inspection in May 2017.
Safe staffing and medicines
Inspectors found enough staff to meet people's needs and support them in the community. Medicines were received, stored and given safely, with regular checks of staff competence.
“There were enough staff to meet people's needs. People were able to access the community and were supported to carry out activities of their choice.” from the report
Kind staff interactions
Inspectors saw staff treating people with warmth and kindness. Staff also noticed when people were becoming distressed and responded proactively.
“Throughout the inspection we observed staff to treat people with warmth, compassion and kindness.” from the report
Personalised activities
People were supported to use accessible communication methods and take part in activities they enjoyed, both at the home and in the local community.
“We saw that people accessed the community regularly to join activities such as swimming, fishing, trips to the cinema and shopping.” from the report
Good management checks
The home had regular checks on safety and quality. Inspectors found the management team open to feedback and focused on improving care.
“The quality assurance system included lots of checks carried out by the registered manager.” from the report
Dignity and institutional language
needs fixingRecords and parts of the environment used language more suited to an institution than a home. Inspectors also found some personal information and care equipment displayed or stored in ways that did not protect privacy.
“People received a service that was not always caring by the use of institutionalised language in records and in the environment.” from the report
Private information on display
needs fixingInformation about long-term health conditions was displayed in the dining area. Some equipment linked to personal care was also visible outside a person's room.
“Information regarding long term conditions were displayed in the dining area.” from the report
Incident debrief records
needs fixingThe home did not record clearly how many debrief sessions had taken place or whether they had been offered to staff involved in incidents. The manager agreed to review this process.
“We found that records didn't reflect the quantity and quality of debrief sessions for staff involved in incidents.” from the report
Communication with families
minorSome relatives said communication could be better and that they did not always feel listened to. The manager accepted this feedback and said further discussions would take place.
“Some family members told us they felt communication could be improved and they hadn't always feel listened to.” from the report
- 01What has changed to stop institutional language being used in records and around the home?
- 02How do you now keep medical information and personal care equipment private?
- 03How are staff debriefed and supported after an incident, and how is this recorded?
- 04How do you make sure agency nurses and new staff understand each person's autism, communication needs and care plan?
- 05How will relatives be kept informed and given a clear response when they raise concerns?
This was an unannounced responsive inspection after concerns were raised with the CQC, and it assessed the home, the care provided and all five key questions. This explanation was written from the published report of 11 July 2019 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 Thornfield Grange
4 rated inspections over 8 years: the service has held its Good rating throughout.
- March 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2019Requires improvementdown from GoodEffective: Requires improvementCaring: Requires improvementWell-led: Good
- May 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- April 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- September 2013
Registered with the Care Quality Commission on 3 September 2013.
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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47 live-in carers within about an hour of County Durham
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £960 to £1,210 a week. 42 can care for a couple. 10 years' experience on average.
“Petty introduced herself to Mum every time she was caring for her and responded very quickly to Mum if she was distressed in the night.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.