Thorne House

During our site visit we observed some practices which did not always promote people's safety. These were brought to the attention of staff during the visit and immediately rectified. We also found some concerns regarding the management of medicines which were also actioned immediately.

People’s care records had recently been transferred onto the new electronic system. We found some areas of care records on the new system were not detailed or information in all the relevant sections. This was also reflected in some risk assessments and information related to mental capacity and best interest decisions. Some checks were also not being recorded at the frequency identified by the care plan. The manager informed us that a review of all records was already underway and care records on the new system were being revised to ensure detailed information was in place for each person.

There were enough staff available to meet people's needs. However, we received feedback from people, families and partners raising concerns about the consistency of staff and agency usage. Recent recruitment drives had been successful, and the number of vacancies was reducing.

People were safeguarded from abuse and avoidable harm. Staff told us they were supported by the new management team and felt confident to raise any concerns. Staff were able to recognise possible signs of abuse and knew how to report such concerns promptly.

Staff received regular training to ensure their skills and knowledge were up to date and enable them to provide safe care.

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.

Staff knew about people’s health needs and personal preferences and gave them as much choice and control as possible. However, people’s care plans did not contain sufficient information about the type of decisions people were able to make and how best to support them to make these decisions.

Staff could describe how they supported people to maintain independence and policies supported this practice. We received mixed feedback from professionals regarding the consistency and skill set of staff in supporting some people to become more independent.

People had access to activities and the local community to promote and support their independence, health, and well being.

People received care and support from staff that reflected their individual needs, including those related to protected characteristics under the Equality Act.

People were involved in planning and making decisions about their care so that it was centred around them and their needs. People received the most appropriate care for them as the service made reasonable adjustments where necessary.

People’s personal, cultural, social, and religious needs were understood and met.

During our assessment of this key question, we found that there had not always been sufficient oversight to fully monitor the quality and safety of the service. However, a new management team was in place and action plans were already in progress to address some of the concerns we found. Where action plans were not in place concerns highlighted were addressed immediately.

The provider had a shared vision, strategy, and culture which staff were aware of.

Staff were positive about the management team and the support they received.

Staff and management were seen to work in partnership with people, relatives, and professionals.

People and most relatives felt the service was managed well and were kept well informed.