CQC report explained · a residential care home
What the CQC found at Thornfield House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and managed, staffing was sufficient and medicines were generally managed safely. One allergy had not been copied from a care plan onto a medicines administration record, but this was dealt with immediately.
- Effective?
- Good
- People's needs were assessed and reviewed, staff received relevant training and people were supported with nutrition, healthcare and communication. The home worked within the Mental Capacity Act principles and made timely applications where required.
- Caring?
- Good
- Staff knew people well and were observed to be kind and supportive. People were involved in decisions about their care and were encouraged to maintain their independence.
- Responsive?
- Good
- Care plans were detailed and regularly reviewed. People had personalised activity plans and access to a good range of activities, but most people did not have their end of life wishes recorded.
- Well-led?
- Good
- The home had clear roles, regular audits and action plans for improvements. People, relatives and staff were asked for their views, and inspectors found confidence in the management team.
What inspectors found, June 2019
Rated Good; inspectors found safe, kind and personalised care, with some records still needing improvement.
The inspection took place on 1 and 14 May 2019. It was unannounced on the first day. The inspector spoke with staff, the manager, one person living at the home and two relatives. They also observed care and checked care records, staff files and management records.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines management, good training and positive relationships between staff and people living there.
The home focused strongly on choice, independence and positive risk-taking. Inspectors found that people were involved in decisions, activities and menu planning, and that relatives were positive about the care.
There were two areas to improve. One person's allergy was missing from their medicines administration record, although this was corrected immediately. Most people also did not have their end of life wishes recorded.
Choice and independence
The home supported people to make choices, take positive risks and build everyday skills. People were encouraged to help with cooking, cleaning, laundry and personal care.
“There was a strong focus on promoting choice, control and independence.” from the report
Kind relationships
Staff knew people well and treated them with kindness and support. Inspectors saw friendly interactions, chatting and laughter.
“Staff had good relationships with people, we observed lots of chatting and laughter.” from the report
Personalised activities
People had activities suited to their preferences, ranging from work placements and shopping to arts and crafts, holidays and visits to family.
“There was a strong focus on people having personalised activity plans.” from the report
Learning from incidents
The management team reviewed accidents and incidents for patterns and used the findings to improve safety. Makaton training was reintroduced after this review.
“The most up to date analysis we reviewed showed this had led to a reduction in incidents.” from the report
Allergy missing from medicines record
needs fixingAn allergy recorded in one person's care plan had not been included on their medicines administration record. The manager corrected this during the inspection.
“In one person's records we found information about an allergy, which was in their care plan, had not been recorded on the medication administration records.” from the report
End of life wishes not recorded
needs fixingMost people did not have their end of life care wishes documented. The manager had already identified this as an area needing development.
“Most people did not have information recorded about their end of life care wishes.” from the report
- 01How do you now check that allergies in care plans are also recorded on medicines administration records?
- 02Have all people's end of life care wishes now been discussed and recorded?
- 03How are people and their relatives involved in reviewing care plans and activity plans?
- 04How will the changes introduced by the new manager be monitored and reviewed?
This was a planned inspection covering all five key questions and the overall quality and safety of the home. This explanation was written from the published report of 19 June 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.
What inspectors found, November 2016
Thornfield House was rated Good; inspectors found safe, kind and personalised care, with a few minor improvements needed.
This was an unannounced inspection carried out over three visits in September and October 2016. Inspectors visited the home, spoke with staff, a resident, relatives and an external professional, and reviewed care records, medicines, staff files, complaints and other records.
All five areas were rated Good. Inspectors found enough suitably trained staff to support people with complex autism and behaviour support needs. Medicines were managed safely, risks and incidents were reviewed, and people were supported with healthcare, food, activities and daily choices.
Inspectors saw kind and respectful care. Care plans were detailed and personalised, and relatives were involved in reviews. The home was well led, although inspectors noted a missing emergency grab bag, some minor decoration issues, inconsistent progress with one communication aid, and staff turnover.
Safe support
Staff understood people's complex support needs and knew how to manage risks, including behaviour that could cause injury. Incidents were reviewed to reduce future risks.
“People were safe living at the service and staff knew how to act to keep them safe from harm.” from the report
Safe medicines
Inspectors found that medicines were given as prescribed, records were complete and staff competency was checked.
“Medicines records were accurate and supported the safe administration of medicines.” from the report
Personalised activities
Each person had an individual timetable. People were supported with education, work, leisure and community activities to help maintain independence and avoid isolation.
“People had access to staff to support a range of internal and external activities and to prevent isolation.” from the report
Quality monitoring
The manager and provider carried out regular checks on medicines, records, health and safety, incidents and care. They used reviews to make changes where needed.
“The registered manager monitored the quality of the service and looked for any improvements to ensure that people received safe care.” from the report
Minor decoration issues
minorInspectors said some redecoration was needed, although the building was otherwise well maintained and adapted for safety.
“The service required some re-decoration but had been adapted to make it safe for the people living there.” from the report
Communication aid
minorA relative said improvements in using a tablet as a communication aid were not consistent. The manager said staff were continuing to work on this.
“One relative told us they had raised an issue about use of a tablet as a communication aid, but that improvement was not consistent.” from the report
Staff turnover
minorFeedback identified staff turnover as the main thing relatives would change. The provider had taken actions intended to reduce turnover.
“These told us that the service was effective and that the only thing that they would change was turnover of staff.” from the report
- 01Has the emergency grab bag been put in place, and what information and essentials does it contain?
- 02What redecoration work was identified during the inspection, and has it been completed?
- 03How do you make sure the tablet communication aid is used consistently and reviewed for effectiveness?
- 04What has the provider done to reduce staff turnover, and how do you maintain continuity for people with complex support needs?
- 05How are changes in behaviour, incidents and restraint reviewed and reflected in each person's care plan?
This was an unannounced inspection of the overall service, covering Safe, Effective, Caring, Responsive and Well-led, with visits on three dates and telephone discussions with relatives and professionals. This explanation was written from the published report of 1 November 2016 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 House
2 rated inspections over 3 years: the service has held its Good rating throughout.
- June 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- March 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 14 January 2011.
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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