Archived: Thorley House Residential Care Home

This comprehensive inspection took place on 05 January 2016 and was unannounced. The inspection team consisted of two adult social care inspectors. At the time of the inspection, there were 37 people living at Thorley House.

Thorley House is registered to provide personal care and support for 40 people. The home is situated in a quiet residential area of Hindley, Wigan, with enclosed secure garden areas.

There was a registered manager in post. 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.

Staffing levels were sufficient on the day of the inspection to meet the needs of the people who used the service. The service took into account people's needs and their dependency level, using a dependency level tool.

We looked at six staff personnel files and there was evidence of robust recruitment procedures.

There was an up to date safeguarding policy in place. Care staff demonstrated an awareness of safeguarding and were able to describe how they would make a safeguarding referral. The home had a whistleblowing policy in place.

We saw requirements relating to controlled drugs were being met. Controlled drugs are certain medicines that are subject to additional legal controls in relation to their storage, administration and disposal.

We saw the member of staff who was administering medicines left the medicines trolley unlocked and the door to the room where it was stored open on repeated occasions. Although no-one approached this area whilst staff were administering medicines, this is poor practice and would increase the risk of inappropriate access to the medicines.

There were no cream charts in place. Staff told us they administered cream medicines then told a senior carer who signed the MAR. There were body maps in place, and these were in peoples’ MAR charts so may not have always been accessible to care staff to ensure they knew where to apply creams.

The home was clean and free from any malodours. Bathrooms had been fitted with aids and adaptations to assist people with limited mobility when bathing and toileting. There were a variety of cleaning schedules in place.

There was an accidents/incidents record book which had been appropriately completed and identified the detail of any incident including the cause and the detail of any immediate and subsequent action that was required to minimise any further risk.

Staff were subject to a formal induction process and probationary period. Supervision sessions for care staff were frequent. Comprehensive staff training records were in place.

The service was complying with the conditions applied to DoLS authorisations and staff told us they had received training in the MCA and DoLS. Staff were aware of how to seek consent from people before providing care or support. People’s care plans contained records of visits by other health professionals. Staff were aware of how to ensure people’s privacy and dignity was respected.

There was a five week seasonal menu cycle that was nutritionally balanced.

There were some adaptions to the environment, which would assist people living with a dementia.

People were treated with kindness and dignity during the inspection. Care staff spoke with people in a respectful manner. Care staff knocked on people’s bedroom doors and waited for a response before entering. We heard lots of laughter between staff and people and there was a positive atmosphere within the home.

People’s communication support needs were well documented in their care plans. At the time of the inspection no person was in receipt of end of life care. Peoples’ bedroom had their picture on the door which would assist people living with dementia to find their own room.

There were records of residents and relatives meetings where discussions had resulted in changes being made within the service. Notice boards contained information on activities on offer.

Care plans were person centred and would allow staff to provide support in line with people’s preferences. People had pre-admission assessments in place, which considered their support requirements. However, the pre-admission assessments we looked at were limited in the information they contained, were not fully completed and had not always been signed by the assessor or person being assessed.

Relatives of people we spoke with told us they knew what action to take if they needed to make a complaint. They told us they had never had to raise a complaint, but would feel comfortable doing so if required. The home had procedures in place to receive and respond to complaints.

Staff said they liked working at the home and told us they thought the home was well led and said that the registered manager was approachable and fair.

There was a full range of policies and procedures in place which were available in paper copy format and electronically.

The service undertook a range of audits, which were competed according to different schedules.

There was evidence in minutes of team meetings that findings from audits were communicated to staff and actions taken.

Accident and incident forms were completed correctly and included the action taken to resolve the issue and the corresponding statutory notification form required to be sent to CQC, where appropriate.

The service worked alongside other professionals and agencies in order to meet people’s care requirements where required.

There was a business continuity plan in place that identified actions to be taken in the event of an unforeseen event.