Archived: Thornbury House

There was a new manager in post who was in the process of becoming registered with the Care Quality Commission. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

We found people’s safety was compromised in some areas. Relevant recruitment checks were conducted before staff started working at Thornbury House to make sure they were of good character and had the necessary skills. However, for some staff unexplained gaps in employment history had not been clarified by the provider.

Staff did not always have the appropriate training to meet people’s needs and ensure their safety. At our last inspection moving and handling training for staff was identified as a need for the service. Staff had still not received this training to support people safely.

The provider did not have an effective system in place to monitor the quality and safety of the service. The provider did not have a duty of candour policy in place. Areas of the home were in need of updating and decorating.

Staff sought consent from people before providing care and support. However further work was required for a best interest decision.

People and their families told us they felt safe and secure when receiving care. Risk assessments were in place which minimised risks to people living at the home and fire safety checks were carried out.

Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse. There were enough staff to keep people safe.

Staff were trained and assessed as competent to support people with medicines. Medication administration records (MAR) confirmed people had received their medicines as prescribed.

New staff completed an induction designed to ensure staff understood their new role before being permitted to work unsupervised. Staff told us they felt supported and received regular supervision and support to discuss areas of development.

People were cared for with kindness, compassion and sensitivity. Care plans provided comprehensive information about how people wished to receive care and support. This helped ensure people received personalised care in a way that met their individual needs.

People were supported and encouraged to make choices and had access to a range of activities. Staff knew what was important to people and encouraged them to be as independent as possible. ‘Residents meetings’ and surveys allowed people to provide feedback, which was used to improve the service.

People received varied meals, including a choice of fresh food and drinks. Staff were aware of people’s likes and dislikes.

Staff were responsive to people’s needs which were detailed in people’s care plans. Care plans were regularly reviewed to ensure people received personalised care. A complaints procedure was in place.

Staff felt supported by the manager and staff meetings took place.

We identified two breaches of regulations. You can see what action we have told the provider to take at the back of this report.

There was a new manager in post who was in the process of becoming registered with CQC. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We found people’s safety was compromised in some areas. Fire alarm tests were being carried out monthly instead of weekly as recommend by fire safety regulations and the homes fire safety policy. The provider had not informed us of incidents of abuse where a person had had altercations with other people living at the home.

Relevant recruitment checks were conducted before staff started working at Thornberry House to make sure staff were of good character and had the necessary skills. However, there were unexplained gaps in staff employment histories. There were enough staff to meet people’s needs.

People felt safe. Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse. People were supported to receive their medicines safely from suitably trained staff and promoted a medicines champion who carried out audits on medicines and records weekly.

The risks to people were minimized through risk assessments and staff were aware of how to keep people safe and information provided staff with clear guidelines to follow and were reviewed monthly.

Staff received regular support and received regular one to one sessions of supervision to discuss areas of development. Staff informed us they completed a wide range of training and felt it supported them in the job role. New staff completed an induction period before being permitted to work unsupervised.

Staff sought consent from people before providing care or support. The ability of people to make decisions was assessed in line with legal requirements to ensure their rights were protected and their liberty was not restricted unlawfully. Decisions were taken in the best interests of people.

People received varied and nutritious meals including a choice of fresh food and drinks. Staff were aware of people’s likes and dislikes and offered alternatives if people did not want the menu choice of the day.

People were cared for with kindness, compassion and sensitivity. We observed positive interactions between people and staff. Care plans provided comprehensive information about how people wished to receive care and support. This helped ensure people received personalised care in a way that met their individual needs.

People were supported and encouraged to make choices and had access to a wide range of activities tailored to their specific interests. ‘Residents meetings’ allowed people to provide feedback, which was used to improve the service. A complaints procedure was in place. There were appropriate management arrangements in place and staff and people felt supported by the manager.

We identified a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. You can see what action we have told the provider to take at the back of the full version of the report.

We spoke with the families of two of the people who used the service. They told us they did not have any concerns over the level of care provided to their relatives. One relative said staff were 'brilliant with [their relative] they know his needs and how to look after him'. The other relative told us 'it is lovely, you couldn't wish for a better place. [Their relative] has a life there of his own. It has helped him considerably'.

We looked at five care plans and saw they were individualised and included the necessary information to inform staff as to the specific care people required. We saw people had been involved in the development of their care plan and had a large pictorial representation of their plan on the wall in their bedroom. We observed care in the communal areas of the home and saw staff interacting with people in a positive way.

We saw the home had effective systems in place to protect people from abuse. One of the people we spoke with told us that staff 'looked after me'. A family member told us their relative was 'safe there. I have no fears. It is the safest place he could be'. We found the home was clean and well maintained. The manager told us they were responsible for overseeing infection control. We spoke with two members of staff and the manager, all of whom said they had received infection control training. Everyone we spoke with told us the home was always clean.

We saw that each person had a person centred plan. We saw that there were monthly key worker reviews with people, these were appropriate to the person and supported by pictorial aids. The manager and the staff were knowledgeable about the care needs of each of the residents. We saw that one person was excited about going for a walk with a visitor. Staff noted that the visitor was late and took the person out for a short walk to prevent them from becoming distressed.

We observed staff encouraging people to take responsibility for managing their own lifestyle and take part in household activities supported by staff when necessary. We saw that there was an appropriate pictorial work schedule displayed in the kitchen. We saw that each person had an activities plan in line with their likes and dislikes. People told us they could choose whether they did things or not.

We observed staff providing care and saw that people looked happy and relaxed. People told us that they felt safe and liked living at the home, saying things like 'it's nice'.