Background to this inspection
Updated
2 October 2019
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 Care Act 2014.
Inspection team
This inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Thornhill House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
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. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with seven people who used the service and four relatives about their experience of the care provided. We spoke with six members of staff including the registered manager, and the deputy manager.
We reviewed a range of records. This included three people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed, including policies and procedures.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and policies. We received feedback from three professionals who regularly visit the service. The registered manager was also able to provide additional positive feedback the home had received from other professionals and family members.
Updated
2 October 2019
About the service
Thornhill House is a care home providing personal and nursing care to 19 people aged 65 and over at the time of the inspection. It is a purpose built, single story home in a countryside setting next to a village.
People’s experience of using this service and what we found
People and their relatives told us the service provided excellent care. They told us how they felt that Thornhill House was their home and that they were supported by caring staff who showed genuine compassion and respect to those living in the home. We saw lots of positive interactions with staff and people, and we could see people enjoyed the company of staff. Staff respected each person's rights and treated them as individuals. Care plans and risk assessments were person centred and they detailed how people wished and needed to be cared for. They were regularly reviewed and updated as required. We observed a strong, community orientated service.
People and their relatives had trust and confidence in the staff and management and everyone, without exception, said they would recommend the service to others.
People, their relatives and other health and social care professionals gave consistent, positive feedback about the service. This included the approach of staff, registered manager and partnership working. One GP told us, “The care there is superb and frankly sets them far apart from the neighbouring care homes.” The registered manager and staff regularly worked with other professionals to ensure the best outcomes for people living in the home.
The provider ensured people had access to a wide range of meaningful activities. This included trips out to places that people said they wanted to visit and events. We saw many examples of where the involvement of the local community had enabled people to feel included and part of their community once again.
The management team had maintained an open and supportive culture in the home. Staff and people using the service told us they felt the registered manager was approachable and accommodating.
Medication was managed safely for the majority. During inspection we identified that the recording of ‘as and when’ medications was not sufficient however the registered manager immediately acted on this feedback. Additionally the premises were very safe, and checks were carried out regularly however the documentation did not reflect this. Again, the registered manager was responsive, open and transparent and immediately actioned this.
Risks which compromised people’s health and well-being were appropriately assessed, reviewed when needed and contained detailed information. People told us they felt safe with the service.
Accidents, incidents, safeguarding and complaints were managed appropriately and monitored by the management.
The registered manager had a range of audits in place and accessed other sources of information to review and improve practice. People were able to give their opinions on their care service and a range of communication methods were in place to ensure people continued to have this opportunity.
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.
Policies and procedures were in place and updated, such as safeguarding, complaints, medication and other health and safety topics. infection control standards were monitored and managed appropriately.
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 Outstanding (report published 31 January 2017)
Why we inspected
This was a planned inspection based on the previous rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Thornhill House on our website at www.cqc.org.uk.
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.