Thorne House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

The provider assessed and reviewed people’s health, care, and wellbeing with them. Staff worked across teams and services to support people. People were supported to live healthier lives and where possible to reduce their future needs for care and support. People were supported to understand their right to consent and empowered to make their own decisions when involved in planning how their care and support was provided. Staff understood the importance of ensuring people understood what they were consenting to and obtaining people’s consent before they delivered care. However, people’s needs including capacity and decision making were not always recorded in sufficient detail in some care plans and risk assessments. People’s communication needs were assessed, and staff interacted appropriately with people according to their needs. The provider ensured a range of accessible information, training and communication tools were available for staff to support people to communicate effectively.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Overall people and their families told us they were involved in care planning and consulted with, where care was reviewed. One person said, “Could look at PCS (Electronic Recording System) with [staff name].” In addition to care plans, person centred plans were also in place for people and reviewed regularly with goals set at each review.

Staff knew about people’s health and social needs and preferences and gave them as much choice and control as possible. Staff told us they tailored the way they communicated with people where people experienced problem with communication. One staff said, [Name 1] uses Makaton and their own signs. [Name 2] will sometimes use picture cards.”

People's needs were assessed before they started using the service to ensure staff understood their needs and preferences. However, some care records on the new electronic recording system required more detail to make them more person centred. This included information related to the Mental Capacity Act and consent. The provider was aware of this, and a plan was in place to review all care records. Staff understood the importance of promoting equality and diversity. Care plans contained information about people's religious beliefs and their personal relationships with their circle of support. People, where appropriate, were supported to attend religious services outside the home. Staff were provided with training in communication e.g. Makaton and people were given information in ways they could understand.

Most relatives told us they were involved in ensuring their relative was receiving care in line with their support plan. One relative commented, “Yes, we have regular care plan meetings, to talk about what [person] needs.’’

Staff were aware of the importance of involving people in all aspects of their care and ensuring they were meeting people’s assessed needs. One staff commented, “A person may talk about their preferences. Others have vocal indicators or gestures. It is also recorded in their care plans. Must go through care plan before supporting someone to know about them.”

In people's care records there was evidence of involvement from other health care professionals where required, and staff made referrals to ensure people’s health needs were met. The provider had systems and processes in place to ensure care was given in line with best practice guidance, for example monitoring daily records to check care was successfully delivered to meet people’s needs. However, some care records on the new electronic recording system required more detail. The new management team had an action plan which included a review of all care records to ensure they contained all the information needed to allow staff to provide effective support.

Relatives were positive about their relationship with staff at Thorne House. One person commented, “Have always had good communication with them. We’ve said, always be honest with us. If they are doing wrong, we tell them, and if they’ve done right, we tell them. We are fair. It’s always sorted out quickly. They do respect us. When staff have been amazing, we tell them.’’

Staff recognised the importance of working in partnership. One staff commented, “Like the people, the teamwork and morale. Working through Covid, everyone pulled together. Close, tight knit, no competition.”

Overall, we saw the provider had successfully worked with partners and had been involved in discussions with them about people care needs. One professional said, “Communication is really good. Made to feel welcome and a nice atmosphere.” However, we did receive some mixed feedback from some professionals regarding progression of agreed actions and consistency of staffing.

The provider had processes in place to ensure staff teams worked together effectively and shared information. Evidence of joint working with partners was available.

People and their relatives told us they received support from staff to access health services. One person said, “Going to see pharmacist today.” Some relatives commented on additional support being provided to support people to lose weight, “[Person] could do with losing weight, they’re trying their best to introduce [person] to more healthy foods’’.

Managers and staff could describe how they supported people to remain healthy and what action they would take if someone’s health changed, or they required additional support. The manager told us, “We ensure people attend all appointments and that annual reviews take place. Individual health trackers are in place and reviews are on PCS (Electronic Recording System). We book appointments as appropriate.”

In people’s records we found evidence of involvement from other professionals such as nurses, social workers, and doctors. Where people needed additional support, we saw involvement of relevant professionals to ensure people received the appropriate level of support. Some care records on the new system needed more detail to ensure staff had access to all the information needed to support someone with their health needs and detailed and up to date information was available for professionals to make informed decisions about a person’s care. Where monitoring of health conditions was in place some checks were not always recorded at the frequency identified in the care plan or clear protocols available for staff available to allow them to support people effectively. People’s nutritional needs were assessed and where appropriate people were encouraged to eat healthier and lead healthy lifestyles.

People and their relatives were mainly positive about the support they received from staff. One relative commented, “Yes, I don’t have problems. I know there is a changeover of staff. [Person] seems happy. If [person] wasn’t, I would know who to speak to.’’

The manager and senior staff told us they worked alongside staff to ensure there was effective monitoring of people’s care and treatment and their outcomes. The manager said, “Always on shop floor doing observations, formal (supervision) and informal during walk-around. Do a handover and do a lot of spot checks and questions.” The provider regularly asked people to give them feedback on their experiences of the care they were receiving. They listened to their responses and tailored the care they gave where this was needed.

The provider regularly contacted people to gather feedback on their care and had systems in place to monitor support provided including on site observations. The manager and staff encouraged people to express their views and concerns and gave them the communication tools to support this. For example, easy read complaint forms were in place. Systems were in place to monitor the quality of the service. Audits took place on a regular basis. Action plans were used to address issues and make improvements to the service where needed. For example, during our inspection, the manager immediately actioned an issue we identified and continued to provide follow up information after the inspection was completed.

During the inspection we observe people making choices about their daily activities. One person said, “Saturday and Sunday I have days off and stay at home. Saturday I’m going to the charity shops this week and then on Sunday I’m staying in.”

Staff demonstrated a good understanding of the principles of the Mental Capacity Act (MCA) and people were supported wherever possible to make their own decisions. One staff commented, “Assume the person can make a choice and support the person to make a choice. May not be wise to staff, but to the person it is meaningful. Support will be in best interest of the person, least restrictive.” The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS)

The provider had suitable policies and procedures in place regarding consent to care and treatment and staff had received training on MCA. The manger was aware of the mental capacity act and associated legislation and DoLS applications had been submitted where applicable. However, some care records on the new electronic recording system did not always contain sufficient information about the type of decisions people were able to make and how best to support them to make these decisions. The manager confirmed that this information would be expanded as part of the review of care records and include any best interest decisions taken. There was a range of accessible documentation to help people understand information as well as support to access advocacy services.