CQC report explained · a nursing home
What the CQC found at Thorp House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Care records and risk assessments were detailed and reviewed regularly. Medicines were generally given as prescribed, but some topical medicines were not safely stored during the inspection and lockable cabinets were installed afterwards.
- Effective?
- Good
- Staff were trained and supported people with healthcare, nutrition, specialist diets and consent decisions. Inspectors recommended reviewing signage and other aids to help people find their way around more independently.
- Caring?
- Good
- This question was not separately inspected or rated in this report.
- Responsive?
- Good
- Care plans reflected people's wishes, communication needs, relationships and personal goals. People were supported with activities, community links and family contact.
- Well-led?
- Good
- Management oversight, audits and learning systems had improved. One incident was dealt with and referred to safeguarding, but it was not initially reported to CQC and was reported retrospectively after inspectors gave guidance.
What inspectors found, February 2023
Rated Good; inspectors found kind, safe care and clear improvements since 2019, with a few issues around medicines storage and orientation.
Inspectors visited unannounced on 6 February 2023. They spoke with people, relatives, staff and a health professional. They reviewed care records, medicines records, staff files and management records. The home was experiencing a COVID-19 outbreak and some staff were off sick.
The home provides nursing, residential and dementia care for up to 41 people. There were 39 people living there. Inspectors found a clean and comfortable environment, enough trained staff, safe medicines practices and care that was kind and respectful.
The overall rating was Good. Safe, Effective, Responsive and Well-led were rated Good. Caring was not separately inspected in this report. The rating improved from Requires Improvement in 2019, and the previous breaches had been addressed.
Kind and respectful staff
Inspectors saw staff treating people kindly and respectfully. Relatives and people also described staff as caring and supportive.
“Staff were observed to be kind, caring and respectful towards people, and welcoming when visitors and professionals arrived at the service.” from the report
Enough trained staff
Despite COVID-related staff sickness, the home maintained staffing levels and inspectors saw staff responding to people's needs.
“Whilst the service did have some staff on sick leave due to the COVID-19 outbreak, remaining staff were covering shifts and staffing shortfalls to ensure required numbers did not change each day, and people received consistent standards of care and support.” from the report
Improved care records
Records had become more detailed and included people's preferences, risks and involvement from relatives where appropriate.
“We identified improvements in the level of detail contained within people's records, to ensure care was personalised, and tailored to meet individual wishes and preferences, with involvement of relatives where appropriate.” from the report
Activities and community links
People were supported to take part in group and one-to-one activities, maintain relationships and attend community activities.
“Staff supported people to try new experiences, and to achieve personal goals.” from the report
Stronger management oversight
The new manager and deputy manager had improved audits, monitoring and learning from incidents and previous inspection findings.
“This had positively influenced change, driven up standards and altered ways of working to ensure people received consistent standards of good care; resulting in a positive change to rating as an outcome of this inspection.” from the report
Topical medicines storage
needs fixingSome creams and emollients were not safely stored, creating a risk of accidental harm. The manager said lockable cabinets were installed after the inspection.
“We identified some people's topical medicines such as creams and emollients were not being safely stored placing people at risk of accidental harm.” from the report
Finding their way around
minorA respite resident did not have the usual bedroom information to help with orientation. Inspectors recommended reviewing signage and other sensory indicators.
“We recommend the service reviews arrangements in place to aid people's independence and orientation within the care environment.” from the report
Incident reporting
needs fixingOne incident involving a person consuming a personal care product had not initially been reported to CQC. The manager received guidance and made a retrospective notification.
“However, had not been referred to CQC.” from the report
Food temperature
minorOne person said their food was sometimes cold by the time it reached them. The manager acted when inspectors raised this.
“1 person told us the food was sometimes cold by the time it reached them.” from the report
- 01How are topical creams and emollients stored now, and when were the lockable cabinets installed?
- 02What signage or other aids are available to help people with dementia or respite residents find their bedrooms?
- 03What changes were made after the person consumed a personal care product?
- 04How do you check that incidents are reported to CQC and safeguarding teams when required?
- 05How will you manage staffing levels and visiting arrangements during a COVID-19 or other infection outbreak?
This was initially a focused inspection of Safe, Responsive and Well-led, with Effective added after the visit; Caring was not inspected separately, and the overall rating used the previous rating for any question not inspected. This explanation was written from the published report of 24 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.
What inspectors found, April 2019
Thorp House was rated Requires Improvement; inspectors found kind care, but staffing, consent, risk management and oversight were not consistently safe or reliable.
Inspectors visited on 9 and 10 January 2019 and returned on 11 January to give feedback and clarify findings. The first visit was unannounced, and inspectors arrived at 6am on the second day to see night-time care. They spoke with people, visitors and staff, reviewed records and looked around the whole home.
The home was rated Good for caring. People described staff as kind and respectful, and inspectors saw positive relationships. Staff were trained and recruited safely, the home was clean, and people generally received enough food, drink and healthcare support.
The other four areas were rated Requires Improvement. There were not enough staff at night, care records did not always reflect changing risks or preferences, and formal consent and capacity decisions were missing in some cases. Medicines records, food service and the systems used to check quality also needed improvement.
The previous inspection in January 2018 also rated the home Requires Improvement in all five areas and found four breaches. The home had met two of those previous breaches, but two remained and three further breaches were found at this inspection.
Improved safeguarding knowledge
Staff had received safeguarding training and understood when and where to report concerns. The home also raised concerns with the local authority when required.
“Staff we spoke with had a good understanding of safeguarding and we saw the home raised concerns with the Local Authority when required.” from the report
Training and recruitment
Staff had received more training since the previous inspection, and new staff described a useful induction. Recruitment checks were completed.
“Staff had received training since the last inspection and all told us how the training had improved in both quality and quantity.” from the report
Clean and well maintained
The home was clean and fresh, with cleaning records and schedules in place. The building and equipment were generally maintained and professionally tested.
“The home was clean and tidy and smelt fresh.” from the report
Activities and healthcare links
The activity programme was well developed and welcomed by people. The home worked with healthcare professionals, including diabetes, falls and mental health teams when needed.
“There was a programme of activities each week and on the day of the inspection the local nursery was visiting with children to play with toys in the lounge area.” from the report
Too few staff
seriousThere were not enough staff at night, and some people had to wait for help. Inspectors saw delays with call bells, support delivered by one person when two were needed, and slow breakfast service.
“There were not enough staff of different roles and skills to meet the needs of people in the home.” from the report
Risks not updated
seriousWhen people's needs changed or they had accidents, assessments and care plans were not always updated promptly or clearly. This meant staff might not understand the current risks or required support.
“We found assessments of people's needs were not updated to identify any areas of risk that required additional support when people's circumstances changed.” from the report
Missing consent decisions
seriousFormal consent was not consistently recorded. Decision-specific capacity assessments and best-interest decisions were missing for bed rails and covert medicines, and one DoLS condition had not been followed.
“We found the provider had not gained formal consent for the delivery of care and support to people in the home.” from the report
Care not always personalised
seriousPeople were not always involved in care reviews, and some preferences or needs were missing or contradictory. Inspectors found examples where care instructions, including diabetes and repositioning guidance, were not followed.
“People were not involved in reviews of their care plan.” from the report
Medicines checks needed
needs fixingMedicines were mostly managed well, but the medicines fridge was often outside the desired temperature range. Some as-required protocols and topical medicines records were incomplete.
“This included the temperature of the fridge which was often out of the desired temperature range.” from the report
Weak quality monitoring
seriousAudits and feedback systems did not reliably identify problems or help the manager spot themes and trends. There was also no development and improvement plan in place during the inspection.
“Audits were completed for key areas of service delivery but these were not effective in identifying the issues found by the inspection team.” from the report
- 01How many staff are now on duty overnight, and how do you make sure two staff are available when a person needs this?
- 02How do you record and review consent, capacity and best-interest decisions for bed rails, covert medicines and other restrictions?
- 03How often are care plans reviewed with each person and their family, especially after a fall, illness or change in support needs?
- 04What has been done to keep medicines at the correct temperature and to complete topical medicines records and as-required protocols?
- 05How are complaints, feedback and care-record concerns now collected, reviewed and used to make improvements?
This was a comprehensive inspection of the whole home, including all five rating areas, care records, medicines, staffing, the premises, activities and food service. This explanation was written from the published report of 13 April 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 Thorp House
4 rated inspections over 7 years: the service has held its Good rating throughout.
- February 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- January 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- May 2011
Registered with the Care Quality Commission on 10 May 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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13 live-in carers within about an hour of Norfolk
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 £990 to £1,120 a week. 9 can care for a couple. 14 years' experience on average.
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