CQC report explained · a residential care home
What the CQC found at Thornton Lodge Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that premises safety work, recruitment checks, safeguarding, risk management and medicines systems had improved. Some staff said more staff were needed first thing in the morning, and inspectors saw social distancing was not always followed during maintenance work.
- Effective?
- Good
- People had appropriate mental capacity and best-interest records where needed. Staff had training and supervision, and people received suitable food, drink and referrals to health professionals.
- Caring?
- Good
- Caring was not examined during this focused inspection. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- Responsive was not examined during this focused inspection. Its previous rating was used in calculating the overall rating.
- Well-led?
- Good
- Inspectors found that monthly quality checks had been introduced and that people, relatives and staff were involved in giving feedback. Management and the culture at the home received positive feedback.
What inspectors found, March 2021
Thornton Lodge Care Home was rated Good; inspectors found safer systems and kind, effective care, with minor concerns about busy morning staffing and social distancing.
This was a focused inspection. Inspectors visited on 9 February 2021 and continued their work by telephone and email until 18 February 2021. They spoke with people living at the home, relatives and staff, and checked care records, medicines records, recruitment files and management records.
The home was rated Good for Safe, Effective and Well-led. Inspectors found that earlier problems with electrical safety, recruitment checks, consent records and management checks had been addressed. Medicines were recorded accurately, staff had suitable training, and people were supported with food, drink and health appointments.
There were some issues to keep under review. Some staff said more help was needed during the busy first part of the morning. Inspectors also saw people were not always socially distanced during an activity while maintenance work was taking place. The home later said this had improved after the work was completed.
The overall rating improved from Requires Improvement to Good. Caring and Responsive were not examined during this visit, so their previous ratings were carried forward.
Medicines were well managed
Medicines were ordered, stored, recorded and given safely. The medication records checked had no missing staff signatures.
“Medicines were ordered, stored, recorded and administered safely.” from the report
Staff training and support
Staff had training in areas including dementia, first aid, fire safety, infection control, moving and handling and safeguarding. Records also showed supervision and appraisals.
“Staff told us they received enough training to support them in their roles.” from the report
Improved management checks
The home introduced monthly checks covering earlier concerns such as recruitment, mental capacity records and premises maintenance.
“Since then, we saw these audits had now been introduced and were completed each month.” from the report
Positive management culture
People, relatives and staff gave positive feedback about management, support and teamwork.
“We received positive feedback from everybody we spoke with about management and leadership at the home.” from the report
Busy morning staffing
needs fixingSome staff said more staff were needed during the busiest part of the morning. They said this did not affect the care people received, but the issue was raised with management.
“There were enough staff to care for people safely, although some staff reported to us more were required first thing in the morning at busier times.” from the report
Social distancing during maintenance
needs fixingInspectors saw that people were not always socially distanced during an activity while maintenance work was taking place. The home said this had improved after the work was completed.
“At the time of the inspection we observed people living at the home were not always socially distanced when an activity was taking place and were congregated in the lounge area.” from the report
- 01How many staff are scheduled during the busiest part of the morning, and how do you respond if people need more help?
- 02What arrangements are now in place to maintain social distancing during activities and any future maintenance work?
- 03How do your monthly quality checks make sure recruitment records, consent decisions and premises safety remain up to date?
- 04How will you keep relatives informed about changes to care, activities and infection prevention arrangements?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 18 March 2021 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, December 2020
Thornton Lodge Care Home was rated Requires Improvement; inspectors found safety, consent and management systems still needed strengthening.
This was an unannounced, focused inspection. Inspection activity took place from 30 September to 13 October 2020, including a visit to the home on 6 October. Inspectors spoke with people, relatives and staff, and checked care, medicine, recruitment and management records.
People and relatives generally said the home was safe. There were enough staff, medicines were managed safely, infection control measures were in place, and staff understood safeguarding. Staff also had training and supervision, and people were supported with food, drink and health appointments.
However, electrical safety work had not been completed promptly, references were missing for two staff before they started work, and some decisions involving restrictions did not have the required mental capacity and best-interest records. Audits had not identified these problems. The home remained in breach of Regulation 17 on good governance and received a warning notice.
The overall rating stayed at Requires Improvement, the same as the previous inspection published in July 2019. This inspection only assessed Safe, Effective and Well-led. The previous ratings for Caring and Responsive were carried forward.
Enough staff
Staffing levels were based on people's needs and inspectors found enough staff to care for people safely.
“There were enough staff working at the home to care for people safely.” from the report
Safe medicines
Medicines records checked during the inspection were complete. Medicines were securely stored and people and relatives said they were given safely and on time.
“During the inspection we looked at four MARs which were all completed accurately with no missing signatures by staff.” from the report
Infection control
Inspectors were assured that the home was using PPE safely, following infection control measures and supporting testing and safe admissions.
“We were assured the provider was using PPE effectively and safely.” from the report
Supportive culture
Staff and relatives gave positive feedback about management. Staff described good teamwork and support.
“Staff told us there was a positive culture at the home, with good team work throughout.” from the report
Electrical safety work delayed
seriousFaults identified in the previous electrical installation report had not been acted on. Inspectors said some had the potential to be dangerous and needed urgent action.
“A number of faults had been identified which had the potential to be dangerous and needed to be acted on urgently.” from the report
Recruitment checks incomplete
seriousTwo staff had started work before references from previous employers were obtained. The references were only chased during the inspection.
“Two members of staff had started working at the home without these references being in place first.” from the report
Restrictions not fully recorded
seriousMental capacity assessments and best-interest meetings were not always completed when restrictive measures were used, including bed rails, sensor mats or crushed medicines.
“We found best interest meetings and decision specific mental capacity assessments were still not completed, particularly where restrictive measures were in place.” from the report
Audits missed problems
seriousThe home's audits did not cover or identify several areas where inspectors found concerns. This led to a continued breach of good governance requirements.
“Audits required further improvement and we noted there was no focus on areas such as staff recruitment, mental capacity/best interest meetings and ensuring the safe maintenance of the premises.” from the report
Mixed views about food
minorSome people said the food was boring or limited. Management said it would seek more feedback about food quality.
“People provided us with mixed feedback about the food at the home.” from the report
- 01Have all faults from the electrical installation report now been repaired, and can you show us the completion records?
- 02Are references obtained and checked before every new member of staff starts work?
- 03How do you record mental capacity assessments and best-interest decisions when using bed rails, sensor mats or crushed medicines?
- 04What changes have you made to your audits since the warning notice, and how do you check that they are working?
- 05What has changed about the food since people gave mixed feedback about its quality and choice?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 11 December 2020 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 Lodge Care Home
9 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- March 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- July 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- June 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2017Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- May 2017Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2016Requires improvementstayed Requires improvementResponsive: Requires improvement
- January 2016Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- October 2014
Report published without a new overall rating.
- August 2014
Registered with the Care Quality Commission on 12 August 2014.
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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