14 Thornhill

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

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

This meant people’s needs were not always met.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager did not always ensure care was consistently tailored to people’s individual needs and preferences. Care plans and other documentation did not always provide clear guidance about people’s preferences, how they communicated their wishes, or how staff should respond in certain situations. Communication tools were also not used consistently.

Staff knew people well, and relatives consistently said staff understood people’s needs and responded appropriately when their wellbeing changed. People were supported to make everyday choices about some activities and meals.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff generally worked effectively with professionals to plan and deliver joined-up care. Professionals described staff as knowledgeable, responsive and proactive, and relatives said communication with the service was good. This helped people access healthcare and supported continuity in care provision.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff communicated effectively with families and professionals, but documentation did not consistently reflect this. Care plans, risk assessments and behavior support records needed to be clearer, better structured and written in plain English. Key information, including outlines of people’s abilities, behavioral management plans, medicine guidance and step-by-step care approaches, were not always easy to follow. This had a direct impact on people because unclear information can lead to variation in how support is delivered.

Communication tools can help people express their choices, understand information and be involved in decisions about their care. Staff had used tools such as Picture Exchange Communication System, and although people had not found them useful staff did not consider other options to effectively communicate with people. Currently no one used any communication aides.

The provider did not actively seek feedback, suggestions, or concerns from people regarding their care, treatment, and support.

Staff generally involved people and those important to them in decisions about their care, although systems for capturing and evidencing this were not always robust.

Systems for collecting and using feedback were not always consistent. Some feedback was out of date, and there was limited evidence of regular surveys or formal engagement. This meant it was not always clear how people's views were used to improve the service.

Relatives said they felt listened to, knew how to raise concerns and were confident staff would respond. A person told us, “Communication is great. I have no hesitation picking up the phone to speak with them and they do the same with me.” This showed people and those close to them were involved in everyday decisions and felt able to speak up.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

People were supported to access healthcare services and community activities. However, variable use of communication tools and limited support to develop social interaction and independence meant some people may not have had equal opportunities to access all aspects of community life in a fully person-led way. This mattered because equitable access is not only about attendance; it is also about ensuring people can participate, understand and benefit from opportunities as fully as possible.

Professionals and relatives confirmed people were supported to access services in a timely way. This helped reduce practical barriers to healthcare and supported people’s participation in the community.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

People generally experienced positive outcomes supported by caring staff, although systems did not consistently ensure equitable experiences.

People were treated with kindness and respect, staff were knowledgeable and people were supported to take part in activities and routines that mattered to them.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

The registered manager did not always ensure people had clear, personalised plans in place to support their future goals and changing needs.

There was a lack of clearly defined goals, aspirations and future planning within care records. Although people had activities and opportunities, these were not always linked to longer-term development, independence or progression, and progress was not consistently recorded. This meant future planning was not yet strong enough to show how people were being supported to grow, adapt and achieve meaningful outcomes over time.