14 Thornhill

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant people were not always well supported or treated as individuals.

This service scored 60 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff always treated people with kindness, empathy and compassion and respected their privacy and dignity.

We observed warm, respectful and engaging interactions between staff and people. Relatives said staff knew people “inside out”. Professionals also gave positive feedback about the quality of care and spoke highly of staff.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities and aspirations.

Staff knew people well and understood their preferences, routines and behaviours. People were supported to take part in activities they enjoyed, stay in touch with family and spend time in the community. Relatives said staff understood people and noticed changes in their wellbeing.

Care records did not always clearly explain people's preferences or how staff should respond when someone was unhappy or distressed. This meant support might not always be provided consistently in a person-centred way if staff were unfamiliar with their needs. We discussed this with the registered manager who confirmed care records would be reviewed.

The provider did not always promote people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

There was limited evidence of structured planning for longer-term goals, and some restrictive practices or communication limitations were not always clearly recorded. Therefore, it was unclear how staff had determined if their actions supported the principles of least restrictive practices or enabled people to become more independent. This mattered because meaningful choice and control should extend beyond immediate day-to-day decisions and should support people to build autonomy and independence over time.

People were supported to make choices about food, some activities and their daily routines. Relatives told us staff regularly offered choices and encouraged people to help with everyday tasks. People also had opportunities to take part in activities at home and in the community. A relative told us, “They’re a lot more independent than what they were and what they would be if still living at home." Records showed there were opportunities for people to engage in activities both in the home and in the community.

The provider listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Staff responded well to people’s day-to-day needs and worked with healthcare professionals when people’s health or wellbeing changed. Relatives and professionals said staff acted quickly and provided good support.

The provider did not always promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

Staff were not always fully supported to carry out their roles. Training records and oversight systems were not always robust, with out-of-date training and inconsistencies in the recording of completed learning.

There was limited information for staff to follow when supporting people and understanding lessons learnt. This meant there were missed opportunities to support staff development and strengthen their competences.

Staff told us they felt supported, valued and were able to raise concerns with managers. Records demonstrated established staff support, including probation reviews, regular team meetings, supervision and appraisal arrangements. Staff contributions were recognised, helping to promote a positive team culture. Low staff turnover further supported continuity and consistency of care for people using the service.