CQC report explained · a nursing home
What the CQC found at Thornton Hall & Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2023
Rated Good; inspectors found kind, personalised care, but some care records were not accurate or complete.
This was an unannounced focused inspection on 23 February 2023. Two inspectors spoke with people, relatives and staff, and reviewed four people's care records, training, recruitment and management records.
The overall rating is Good. People and relatives described attentive staff, good communication and personalised care. Inspectors also found that people were supported to make choices and that the home worked within the Mental Capacity Act.
The Effective rating remains Requires Improvement. Some records did not clearly show that care had been provided, including action taken when one person had pain and advice intended to reduce another person's choking risk.
The Responsive rating improved from Requires Improvement to Good. Well-led remained Good. The overall rating changed from Requires Improvement to Good, although this inspection did not newly assess every key question.
Personalised care
Care plans reflected people's individual needs, preferences and important relationships. Staff said this information helped them provide the care people wanted.
“People received planned and personalised care and support which was individual to their needs and preferences.” from the report
Positive relationships
People and relatives described staff as attentive and communicative. Relatives were involved in care planning and kept up to date.
“People told us staff were attentive to their needs and showed flexibility in meeting their requests.” from the report
Choice and consent
The home supported people to make their own choices where possible. Inspectors found mental capacity and best-interest records, along with relevant DoLS applications or authorisations.
“The provider was working in line with the MCA.” from the report
Leadership and oversight
The management team was described as caring and approachable. Audits, incident reviews and staff meetings were used to identify and follow up improvements.
“A range of audits were completed regularly, covering all areas of the service; they showed when areas for improvement were identified, action plans were created and followed up on.” from the report
Incomplete care records
needs fixingSome records did not accurately show the care people needed or the action staff had taken. The CQC recommended improving how records are kept.
“We found inconsistent information recorded in some people's care plans with regards to their assessed needs.” from the report
Pain and choking information not recorded clearly
needs fixingOne person's records described pain and discomfort over nine hours without recording timely staff intervention. Another person's care plan did not include specialist advice intended to reduce choking risk.
“Another person's care plan did not reflect advice given from specialists such as the speech and language therapy team to prevent the risk of choking.” from the report
- 01How will you make sure care plans always include current specialist advice, especially advice about choking?
- 02How do staff record pain, discomfort and any medicines or other action offered?
- 03What checks are now being made to ensure daily care records are accurate and complete?
- 04How will you show that the recommendation about care records has been put into practice?
- 05Which ratings were carried over from the previous inspection because they were not assessed this time?
This was a focused inspection of Effective, Responsive and Well-led; Safe and Caring were not newly assessed and the report says ratings for uninspected key questions were carried over from the last inspection. This explanation was written from the published report of 18 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, February 2023
Rated Requires Improvement; inspectors found safe, kind care overall, but some time-sensitive medicines were not always given at the right times.
This was an unannounced focused inspection on 15 and 19 December 2022. Inspectors looked at Safe and Well-led because concerns had been raised about medicines, staffing and managing people's care needs. They spoke with people, relatives and staff, observed care, and checked care, medicine, recruitment and management records.
The home was rated Good for Safe and Good for Well-led. Inspectors found enough staff, safe recruitment, clean surroundings, suitable infection control and systems to manage risks. People were described as being treated with kindness, dignity and respect.
There was one important area to improve. Some time-sensitive medicines were not always given at the required times or with the right gap between doses. The inspectors made a recommendation about this. The overall rating remained Requires Improvement because the other three question ratings were carried over from the previous inspection.
Enough staff
Inspectors found enough suitably qualified staff to support people safely. People's needs were used when deciding staffing levels.
“There were enough suitably qualified staff to support people.” from the report
Kind and respectful care
Staff treated people as individuals and respected their dignity. People and relatives said they felt safe and well cared for.
“People were supported by kind and caring staff who treated people as individuals and with dignity and respect.” from the report
Clean and safe environment
The home was clean, staff used suitable protective equipment, and infection control and visiting arrangements were in place.
“Appropriate plans were in place to ensure infectious outbreaks were managed safely. The home was clean throughout.” from the report
Good management checks
The home monitored quality and safety, followed up actions and used incident information to improve care.
“The quality and safety of the service was well monitored and follow up actions had been taken appropriately.” from the report
Timing of some medicines
needs fixingSome time-sensitive medicines were not always given at the required time or with the necessary gap between doses. Inspectors made a recommendation for the home to improve its practice.
“Some medicines administration records showed that these medicines were not always given at the right time or with the necessary gap between doses.” from the report
- 01What changes have you made to ensure time-sensitive medicines are given at the correct times?
- 02How do you check that the correct gap is kept between doses of medicines such as Parkinson's medicines or antibiotics?
- 03What action do you take if a time-sensitive medicine is late or the gap between doses is not correct?
- 04How do you use feedback from residents and relatives to improve care?
- 05Which ratings from the previous inspection have not yet been reassessed?
This was a focused inspection of Safe and Well-led, with infection control also reviewed; the other ratings carried over from the last inspection. This explanation was written from the published report of 3 February 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.
Every inspection of Thornton Hall & Lodge
7 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- March 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- February 2023Requires improvementstayed Requires improvementWell-led: Good
- May 2021Requires improvementstayed Requires improvementSafe: GoodWell-led: Good
- December 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- November 2019Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2019Inadequatedown from Requires improvementSafe: Requires improvementEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- July 2018Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2018
Registered with the Care Quality Commission on 5 March 2018.
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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38 live-in carers within about an hour of Sefton
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 £980 to £1,270 a week. 34 can care for a couple. 11 years' experience on average.
“He developed a close affinity with Terence, spending time talking with him before he retired to bed and looking after his needs during the night.”
“It was clear that she genuinely cared and her warm approach really helped put our minds at ease.”
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.