CQC report explained · a residential care home
What the CQC found at Thornton House Residential Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, February 2024
Rated Inadequate and placed in special measures; inspectors found serious safety and management failures despite improvements in staffing, medicines and safeguarding.
This was an unannounced follow-up inspection on 27 November, 29 November and 6 December 2023. Inspectors spoke with people, relatives, staff and visiting professionals. They reviewed care records, staff files, policies and other records, and observed care.
The overall rating remained Inadequate. Safe and well-led were rated Inadequate. Effective, caring and responsive were rated Requires Improvement. The home was still not managing risks properly, and its checks and records were not reliable.
There were improvements. Staffing was sufficient, medicines were managed safely, safeguarding arrangements had improved, and some parts of the building had been refurbished. Relatives and professionals also said communication and care had improved under the new manager.
The home remained in breach of Regulation 12 and Regulation 17. CQC will request an action plan, work with the local authority and continue monitoring the home. Special measures mean CQC will usually re-inspect within six months and may take action to stop the home operating if there is not enough improvement.
Staffing
Inspectors found enough staff to meet people's needs. The provider had improved how it assessed staffing levels.
“There were sufficient numbers of staff deployed to meet the needs of the people supported.” from the report
Medicines
Medicines records were accurate and medicines were stored safely. Staff who gave medicines had training and competency checks.
“Medicines were managed safely by trained and competent staff.” from the report
Safeguarding
Safeguarding systems had improved. Suspected abuse was reported and acted on promptly, and staff knew how to raise concerns.
“When suspected abuse had been identified, prompt and appropriate action had been taken to safeguard people.” from the report
Food and healthcare
People's nutritional needs and preferences were assessed. The chef understood individual dietary needs, and people were supported to access healthcare professionals.
“The chef was knowledgeable about people's individual needs and preferences as well as dietary requirements.” from the report
Unsafe environment
seriousInspectors found damaged and uncleanable surfaces, unsafe electrical work, trip hazards, poor laundry arrangements and other risks that had not been properly assessed or addressed.
“There were many examples of health and safety risks and poor practice the provider had failed to identify, mitigate, and address” from the report
Weak safety and quality checks
seriousAudits did not identify serious problems with bedding, care plans and the environment. The provider had also failed to act on some recommendations from professional bodies.
“Quality assurance systems were not robust. There were many examples where the provider had failed to identify audits were ineffective, and records were not accurate and complete.” from the report
Care plans not up to date
needs fixingSome care plans did not match people's current needs or the support being given. This could make it harder for staff to provide consistent care.
“Care plans had not always been updated when people's needs had changed so did not reflect their current needs.” from the report
Poor bedding
needs fixingSeveral beds had torn or threadbare sheets, and inspectors saw further damaged bedding later in the inspection. This did not promote people's dignity.
“On the first day of the inspection the sheets on 5 people's beds had holes in and another was thread bare.” from the report
- 01What immediate action has been taken to remove the infection control and health and safety risks identified by inspectors?
- 02How are you now checking that care plans accurately reflect each person's current needs?
- 03How will you make sure agency staff receive care plans, risk assessments and guidance before they start work?
- 04What activities and one-to-one engagement are available for people who stay in their bedrooms or are not interested in group activities?
- 05What is the timetable for completing the outstanding refurbishment, furniture replacement and repairs?
This was an unannounced follow-up inspection of all five key questions, checking actions required after the previous Inadequate inspection. This explanation was written from the published report of 6 February 2024 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 2023
Rated Inadequate and placed in special measures; inspectors found serious risks involving safeguarding, staffing, dignity, care planning and management.
Inspectors made unannounced visits on 14, 15, 17 and 20 March 2023. They spoke with people, relatives, staff and professionals, observed care and reviewed care records, staff files and management records.
The home was rated Inadequate in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that incidents were not always reported or investigated, staffing and training were not sufficient, and some people were at risk of harm.
Care plans and risk assessments were not consistently accurate or detailed. People were not always treated with dignity, offered choices or supported with their communication, food, drink and activities. The building also needed repair, refurbishment and clearer signage.
There were some positive findings. Medicines were managed safely, recruitment checks were completed and infection prevention arrangements were suitable. However, the overall rating fell from Good at the previous inspection, published on 3 August 2021.
Medicines
Medicines were stored and recorded safely. Staff who administered medicines had training and competency checks.
“Medicine administration records (MARs) were accurate and up to date. All medicines, including controlled drugs, were stored safely.” from the report
Recruitment
The home completed appropriate checks before employing staff.
“Recruitment processes were safe. Appropriate pre-employment checks were carried out to ensure that only suitable people were employed.” from the report
Infection control
Inspectors were assured that infection risks were being managed, including the use of protective equipment and arrangements for outbreaks.
“We were assured that the provider was using PPE effectively and safely.” from the report
Dietary knowledge
The chef understood people's individual dietary needs, preferences and requirements.
“The chef was knowledgeable about people's individual needs and preferences as well as dietary requirements.” from the report
Safeguarding failures
seriousPeople had come to harm and prompt action had not always been taken. Safeguarding alerts and incident reports were not consistently made, so lessons were not learned.
“People had come to harm and prompt and appropriate action had not been taken to safeguard people.” from the report
Staffing and training
seriousThere were not enough suitably trained and competent staff. Training did not cover important areas such as dementia care and positive behaviour support.
“There were insufficient numbers of suitably trained and competent staff employed to meet the needs of the people supported.” from the report
Dignity and respect
seriousSome records used disrespectful language, and inspectors saw staff speaking to people in ways that were not always kind or person-centred. Relatives also said they sometimes provided personal care themselves.
“People were not always treated with dignity and respect. This was a breach of regulation 10(1) (Dignity and respect)” from the report
Care plans and risk information
seriousSome care plans were inaccurate, unclear or out of date. People living with dementia did not have clear guidance for staff, increasing the risk of inappropriate support.
“People living with dementia did not have any clear plans or guidance in place to guide staff about how best to support people on their dementia journey.” from the report
Building condition
seriousCommunal areas, bedrooms and bathrooms needed refurbishment and repair. Lighting and signage did not fully support people living with dementia, and a bath lift had been out of service for an extended period.
“Premises and equipment were not always suitable for the purposes being used, and properly used and maintained.” from the report
Activities and choice
needs fixingActivities mainly involved loud music and films. People were not always offered a choice about where to spend time, and people in their bedrooms were not consistently offered one-to-one engagement.
“People who chose to spend time in their bedrooms were not offered any engagement. For example, 1:1 time, reminiscence or reading.” from the report
- 01What safeguarding incidents have occurred since the inspection, and how were they reported, investigated and used to prevent further harm?
- 02How many staff are on each shift, and what dementia and positive behaviour support training have they completed?
- 03Which residents now have updated care plans and risk assessments, especially people living with dementia or showing behaviour that may challenge?
- 04What has been done to improve dignity, personal care, communication with relatives and people's access to activities?
- 05Which repairs and refurbishment work has been completed, including the bath lift, bedroom carpets, lighting, signage and bathrooms?
This was an unannounced full inspection covering all five key questions, the care provided and the premises, with infection prevention and control also checked. This explanation was written from the published report of 22 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.
Every inspection of Thornton House Residential Home
11 rated inspections over 9 years: the service has slipped, from Requires improvement to Inadequate.
- February 2024Inadequatecurrent ratingstayed InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
Read what inspectors found at Thornton House Residential Home →
- November 2023Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
Read what inspectors found at Thornton House Residential Home →
- August 2021Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- November 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Inadequate
- January 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2016Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- February 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2015Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- March 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- March 2012
Registered with the Care Quality Commission on 15 March 2012.
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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84 live-in carers within about an hour of Cheshire West and Chester
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Most charge £980 to £1,260 a week. 76 can care for a couple. 10 years' experience on average.
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