Thornage Hall Independent Living

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment, and support achieved good outcomes and promoted a good quality of life, based on best available evidence. This was an aged, rated inspection for Thornage Hall. At our last inspection we rated this key question good. At this inspection, the rating for this key question has remained good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care,well being, and communication needs with them.

Thorough assessments were completed prior to admission and often people were already known to the service as they accessed day services. Annual reviews were held both internally and with the local authority to consider any changes in the person’s needs and the continued suitability of the placement. Another building was available and the provider was waiting for the local authority to agree commissioned support which would be more appropriate to people with advancing needs.

Relatives told us they had been involved with Thornage Hall for a long time and were comfortable with what they could provide and said the service had been a lifeline.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

The provider was aware of any underpinning legislation, including Right Support, Right Care, Right Culture and best practice and ensured policies were kept up to date, and staff followed the relevant policies, and staff training was kept up to date.

People’s care plans considered outcomes they wished to achieve, and considered people’s preferences, interests, and needs.

People were supported to access health and social services and a range of therapies from both primary and secondary services and complimentary therapies. the provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, well-being, and communication needs with them.

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

People received continuity of support with permanent staff on every shift and agency staff occasionally supplementing staff absence. Shifts included oversight from team leaders and shift leads.The registered manager was proactive in ensuring the site ran smoothly completing daily walk around's. People came into the office at the end of the day to share their daily experiences. 1-1 support was well organised to ensure people could pursue their own interests or be supported in a small group based on their needs.

There were excellent networks with the wider community and a genuine sense of community within ThornageHall with some people living and working on site and others just attending the day services. Thornage Hall organised community events and encouraged people to attend clubs and activities within their community.

The provider always supported people to manage their health and well-being to fully maximise their independence, choice, and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People had access to the services they needed and were supported to make and attend appointments. Home visits could be arranged or staff supported people to access appointments.The registered manager worked closely with the learning disability team and other professionals including the learning disability nurse at the hospital.

Healthy eating was considered alongside other health considerations and people were supported to stay active and understand where their food came from using both produce,they had grown themselves or using online or in person shopping. One staff member told us, “We have a monthly menu in place, and discuss it at our monthly meetings,and change it based on what the tenants want. We do make it as healthy as possible and try to cook everything from scratch rather than buying processed foods.”We observed staff supporting people to make their own meals.

In addition, people had strong routines where they were active for most of the day and then attending leisure activities which helped them keep fit. A family member commented on their relative doing a lot of walking and being supported to be more health conscious which they welcomed and said they had lost weight.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

People were thriving at this service and achieving what they wanted to do including enjoying group, individual or family holidays. Day activities included supported employment and independent living skills like budgeting, shopping, and travelling independently.

A key worker system helped ensure people had a named contact who could take matters forward and follow things up. This included keeping family members informed of any changes and families confirmed they had been invited to reviews at least annually sometimes more.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.We saw evidence that initial assessments were carried out before the commencement of service delivery.

People were observed making their own decisions and being supported to make choices. Family members were involved in people’s support and often held power of attorney or deputyship to support their relative with finance, or more complex decisions.The least restrictive practice was in place for day-to-day practices. All staff were trained to support people who might have additional communication needs and staff used positive behavioural strategies to reduce people’s distress and anxiety. The registered manager said communication tools were used when appropriate to help people understand their routines such as now and next boards.

Staff were able to tell us how they promoted choice in line with people’s care plans and assessments indicated if a best interest decision was required. Staff said they supported and guided people but recognised that people could sometimes make unwise decisions.Staff told us how assistive technology at times helped promote people’s safety without restricting their freedoms.

We raised concerns about snack boxes and if this was the least restrictive practice as people could have daily healthy snacks, but unhealthy snacks were limited. We were assured by the registered manager that this was not a blanket approach but agreed by people who had capacity to consent that this would help them manage their eating habits and whilst some people kept their own snack boxes, others were offered snacks regularly with staff saying,‘They would eat all their snacks at once.or ‘take other people’s snacks.”Consent was documented.

Staff received training around the application of the Mental Capacity Act 2005 and codes of practice and its practical application. Person-centred care was delivered which underpinned people’s human rights and the Equality Act 2010. We observed staff supporting people in line with their needs and preferences.