Thornton House Residential Home

Updated 6 February 2024

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors and a regulatory coordinator.

Service and service type

Thornton House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Thornton House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection we spoke with 2 people who lived at the service and 6 relatives and visitors of people who lived at the service. We spoke with the registered manager, area manager, activities coordinator, senior support worker, 2 support workers, 2 x chefs, maintenance person and 1 domestic member of staff. We also spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We received written feedback from 2 health care professionals who visited the service. We reviewed a range of records which included 8 people’s care records. We looked at 2 staff files in relation to recruitment and a variety of records relating to the management of the service including policies and procedures were also reviewed.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We also took photographs of the environment, furniture and fittings and some records.

Updated 6 February 2024

About the service

Thornton House Residential Home is a residential care home that was providing personal care to 22 older people at the time of the inspection. The service can support up to 22 people in one adapted building. At the time of the inspection there were 14 people with age related conditions, including dementia, living at the service.

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

Governance systems remained ineffective. Quality assurance systems were not robust. and records were not accurate and complete. Poor practice was allowed to carry on and the provider did not properly identify or mitigate risks to the health and welfare of people living at the service. The provider had failed to act on actions and recommendations issued by professional bodies.

Improvements had been made to the environment although there remained substantial concerns and areas for improvement. Some areas of the service had been redecorated and communal bathrooms and some communal toilets had been updated and replaced.

Improvements had been made to ensure people were protected people from the risk of abuse and improper treatment. Incidents and accidents involving people were reported, recorded, investigated and lessons were learned.

Improvements had been made to staffing. There were enough trained staff to meet people’s needs. Staff had received mandatory training and training in relation to dementia care.

Improvements had been made and visitors were welcomed at any time and their access to communal areas of the service were not restricted. People enjoyed the group activities on offer but there was little else on offer for people to be engaged in or stimulated by.

Medicines were managed safely by trained and competent staff.

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

People’s food and drink needs were met. The chefs had a good understanding of people’s dietary needs.

Relatives, social care professionals and staff felt the new manager had improved the quality of the service people received and was open and transparent.

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

Rating at last inspection and update

The last rating for this service was Inadequate (22 November 2023).

Previous breaches

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was carried out to follow up on actions we told the provider to take at the last inspection. The overall rating for the service has remained inadequate based on the findings of this inspection.

Enforcement

We have identified breaches in relation to Regulation 12 Safe Care and Treatment and Regulation 17 Good Governance at this inspection. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.