Archived: Thornfield Care Home - Lymington

Thornfield Care Home is a residential care home providing personal care to people aged 65 and over, some of whom are living with dementia and mental health needs. The service can support up to 17 people. 17 people were living at the home at the time of the inspection. The home is owned by Mr M and Mrs S Poordil who are referred to throughout as the provider. Mrs S Poordil is also the registered manager for the service.

People’s experience of using this service and what we found

People and their relatives told us they felt safe living at Thornfield Care Home. There were always plenty of staff around who responded quickly to requests for help. Staff had received training in safeguarding people from harm and knew how to identify, prevent and report abuse. Relevant recruitment checks were conducted before staff started working at the service to make sure only suitable staff were employed. Environmental risks were assessed, and measures were in place to reduce and manage these risks. Staff knew people well and how to identify, assess and mitigate any risks to their safety. Medicines were managed safely and effectively by staff who were trained and competent to do so.

Staff received frequent training, support and supervision and felt supported by the management team. People were supported to maintain a balanced diet. Staff were aware of people's likes and dislikes and any allergies and special diets. People were supported to maintain their independence and have choice and control in their lives. Where people lacked mental capacity to make decisions, these were made in line with the Mental Capacity Act and staff supported people in the least restrictive way.

People were treated with respect, dignity, kindness and compassion. We observed, and people and relatives told us, that the staff were kind, helpful and friendly. People and their relatives felt involved in reviews and decisions about their care.

There was an open and positive culture within the home and people and their relatives told us the management team was approachable and helpful. There were robust management arrangements in place and systems to monitor the quality and safety of the service provided.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good in March 2020.

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Thornfield Care Home is a care home, providing personal care to older people 65 and over, some of whom are living with dementia and mental health needs. The service can support up to 17 people. The home is owned by Mr M and Mrs S Poordil who are referred to throughout as the provider. Mrs S Poordil is also the registered manager for the service.

People’s experience of using this service and what we found

People and relatives told us they were very happy with the care and support they received. Staff were caring, thoughtful and respected their privacy and dignity. We observed this was the case during the inspection. People said their wishes were respected and they felt involved in decisions about their care. People were encouraged to be as independent as possible. The home was friendly and welcoming. Family and friends felt welcomed by staff who knew them well and involved them in daily life at the home.

People and relatives told us they felt safe at Thornfield Care Home and were very happy with the care people received. Staff understood their responsibilities in safeguarding people and the provider shared any concerns appropriately with the local authority and CQC. The provider carried out recruitment checks which ensured only suitable staff were employed, although most staff had been in post for many years. There were enough staff on duty to meet people’s needs and keep them safe. Risks to people’s health and wellbeing had been identified and measures were in place to reduce any risks. Accidents and incidents were investigated by the registered manager and learning shared to reduce risks of reoccurrence. Staff received training in administering medicines which were safely managed.

Staff obtained consent from people for day to day decisions about their care. People without capacity to make decisions were supported in line with the Mental Capacity Act 2005 to ensure their rights were protected. People were supported to maintain optimum health and wellbeing and had access to routine and preventative healthcare services when needed. People had a choice of nutritious, homecooked foods and were offered assistance to eat their meals if required.

Staff knew people very well including their likes, dislikes, preferences and wishes and were responsive to their care and support needs. People enjoyed a variety of activities which helped them maintain their health and interests. People and relatives knew who to speak to if they needed to raise a complaint and felt confident they would be listened to.

The management team had implemented an electronic system for care planning and monitoring the delivery of the service. They had developed a range of quality monitoring systems, such as surveys and audits, and feedback was used to help drive improvement. Where we identified issues during the inspection, these were raised with the registered manager and provider and action taken to address these. People, relatives and staff spoke very highly of the registered manager and provider and the positive impact they had. Staff told us the registered manager and provider were approachable and always available for support and guidance.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was ‘Good’ (Published 1 August 2017)

Why we inspected

This was a planned inspection based on the previous rating.

At the last inspection in April 2015, the service was rated good. At this inspection we found that the service remained good.

The service had a registered manager who was also the registered provider. 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 and associated Regulations about how the service is run.

Staff had received training in safeguarding adults, and had a good understanding of the signs of abuse and neglect.

Safe recruitment practices were followed and there were sufficient numbers of experienced staff to meet people’s needs.

People were supported by a staff team that received the training, supervision and support that they needed to provide people with care and support that met people's needs.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this in practice.

Improvements were planned to update aspects of the premises and make the design and layout of the home more suitable for people living with dementia.

People told us the food was tasty and that they were supported to have enough to eat and drink.

People told us they were supported by staff that were kind and caring and that they were treated with dignity and respect.

Care plans contained the information needed to support staff to provide people’s care in a manner that was responsive to their individual needs.

People were supported to take part in activities which they told us they enjoyed.

People spoke positively about how well organised and managed the service was.

There were systems in place to assess and monitor the quality and safety of the service and to ensure people were receiving appropriate support.

People were provided with a choice of suitable and nutritious food and drink. We saw a copy of the menu which was nutritionally balanced and varied with two choices of meal each day. The registered manager told us that some people had asked for different meals to be added to the menu. One person who used the service told us: 'We are always given two choices of food at lunch time. There is other food available if I changed my mind'.

Appropriate checks were undertaken before care workers began work. We looked at the personnel records for four care workers. These confirmed that they had been interviewed, that references had been requested and that the provider had completed appropriate background checks before they started work at the home.

The registered manager told us how she ensured people were kept safe from harm or risk by undertaking regular audits. We saw that these audits included, for example medication, the environment and food hygiene. The registered manager said that any areas identified as needing improvement would be discussed at the staff team meetings and plans put in place to improve the service.