Thornage Hall Independent Living

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.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 needs were met through good organisation and delivery.

This service scored 79 (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 always made sure people were at the centre of their care and treatment choices, and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Throughout our observations and discussions, we found the service embraced the principles of person-centred care and treating each person as an individual with their own set of circumstances and needs. A family member talked about their relative being in a very dark place before coming here and now living their best life. Another described how they were now with their family. People were keen to showcase what they were doing or planned to do, from showing us around their homes and telling us how they did their laundry, cooking, shopping, medicines to showing us their bedrooms which were all unique and personalised as people were involved in choosing colour schemes and taking pride in where they lived. Relatives told us that when refurbishment occurred people were consulted: including the old hall to decide on colours etc. Meeting minutes prioritised what people wanted including more control over the food budget and more choice in food and areas for refurbishments. Suggestions were acted upon quickly.

There was an emphasis on supporting people at their own pace around their own needs whilst maintaining a routine and regularity which helped people feel safe. A staff member told us, “I love it here there is a lot of freedom to go out, and people use the bus to go into town. There’s always something going on. ”We observed the morning routines as people went off to work or structured activities and then returned for lunch and again had afternoon and evening routines and weekend activities. People had strong links and support with family, friends, and the community. We met a person who was going off to a different town using the bus with a clear contingency should the bus not be running or delayed. We found risk assessments were in place for all activities. People told us they went bowling, fuse night club, shows, music, barbeque, and art classes. A family member told us how their relative had benefited for art and how this had helped them to express themselves and process emotions.

One person told us they had just been accepted as a volunteer at a local tourist attraction and told us they worked on the farm at Thornage Hall helping, with the cows, chickens and alpacas which they helped to shear and helped with the fodder for the animals. They told us they drove the tractor and considered themselves lucky to live here.On site people benefited from life skills, current affairs, music, farm, physical activity, cooking, nature, conservation and IT. People also had every opportunity for activities in their community. For example,1 person attended a choir, another martial arts, another enjoyed wrestling and would go and watch this. Another had regular access to the gym, and another worked at a local farm shop whilst they were able. Trips to local events and shows were regularly organised. People were also supported with more routine tasks such as helping the maintenance team with vehicles,

People decided within their care reviews, tenants’meetings and 1-1 support with their key worker what they would like to do and achieve,and this was then supported and recorded. For example,1 person had obsessive behaviours but was supported to enjoy what they liked in moderation within clear agreed safety parameters. One person went to church in the local community and staff recorded whether people had beliefs or religions they would like to follow. The reverend from the local church visited once a month,and there were also musical keys,and a reflexologist.

A staff member told us how important it was to maximise independence for people and not doing tasks for them, whilst recognising they needed support for their well-being and improving their quality of life.

People also had clear sexuality care plans looking at the support they needed in terms of relationships both friendships and more intimate relationships.

Staff supported self-advocacy by facilitating person-centred planning, and ensuring people’s voices were heard in decision-making, and people were supported to achieve individual goals creating a greater sense of self autonomy,and well-being.

A person told us there was a memory garden where people could go to remember those no longer here and put a plaque of remembrance. People made scented cushions as a reminder of people they had lost. In 1 house,a person had moved in with their relative who had unfortunately passed away some years later. With agreement of other people, their favourite chair remained in situ and people spoke fondly of them. Houses were full of memories and activities people had enjoyed together including community events, barbeques in the summer and long distant holidays with family, with each other or in small groups.

Annual general meetings (AGM) gave the relatives opportunities to comment on the service and quarterly meetings involved both people using the service and relatives who could influence change. Events were well publicised by a regular newsletter. Comments from the recent AGM included: ‘I am constantly grateful to you and the entire staff for all that you do and for all the opportunities that you create in order for the tenants and day service users to develop to their best, to enjoy what they do, to make worthwhile contributions and to lead meaningful lives.’ Another relative had stated,’ You are incredibly supportive to us as a family, and we really appreciate all that you do. Please pass on my gratitude to all the team. ’Relatives praised efforts of the service in continuously trying to raise funds for the benefit of people using the service including Christmas fairs selling their own produce, carol services, and pantomimes. The registered manager said a lot of people went to their families for Christmas, but Christmas was a magical time of the year when they got together, and trips were planned and organised well ahead of the festive season.  

Care plans were developed around people’s original assessments and adapted over time with agreed outcomes for people and regular communication about their needs. The registered manager talked about collaborative support which was evidence from reviews that any change in need was followed up and included more recently oral health assessments and audiology appointments and planning for the future with whole life care plans and future support. Communication was aided by pictorial information, visual timetables,and tenant information, such as a service user guide.

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.

People were able to access their communities and did so on foot, using public transport, and vehicles were available for use.

The registered manager was proactive in understanding the needs of her team, work force planning,and resources. They ensured people were given opportunities to access work,volunteering experiences and pursue their own pathways.

People had support of families who were proactive and supported the service to continue to thrive and have a unique selling point which had been adapted over the years.

The provider supplied appropriate, accurate, and up-to-date information in formats that were tailored to individual needs.

Information was accessible and people were supported to access and share their information on a need-to-know basis.

The service complied with information sharing standards. One person told us they could access their care plan if they wished.Care plans were made accessible for people to discuss and amend particularly in care reviews and when goal setting.

Family members said they were invited to meetings and had rotating chairs for the tenant/ relative meetings held with the trustees to consider improvements and forward planning of the service.

Newsletters helped keep people informed of the ‘trusts’ actions and relatives told us there was an open-door policy and they could visit and or receive regular updates at their request.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment, and support. Staff involved people in decisions about their care and told them what had changed as a result. 

A record of compliments and complaints were seen, and these were responded to in an appropriate manner. Surveys and meetings gave opportunities for people, staff, and relatives to raise issues and staff told us they were confident to do so and felt respected and listened to. Families agreed and we were given an example of a concern that was raised and how the registered manager responded immediately to try and resolve it to the satisfaction of the person involved and their family member.

‘You said we did’ communications clearly showed what actions if any had been identified and acted upon and people had opportunities to raise areas of concern or make suggestion within their house or raise concerns individually.

Whilst we observed good and positive communication. We spoke to relatives about continuity of care and changes within the service and they felt social stories might help as a way of addressing ‘sadness’ experienced by people when staff left or there was a change in their roster. Some people were experiencing declining cognitive functioning and required reasonable adjustments,and we suggested life story work.

The provider made sure that people could access the care,support and treatment they needed when they needed it.

People were supported to stay healthy and reduce the impact of ill health associated with unhealthy lifestyles and diet. People had annual medical reviews to ensure their medicines remained appropriate and any underlying health issues were well managed and any symptoms identified. People accessed in house and community health and social care facilities and were supported to keep up with hobbies and interests which kept them physically fit and emotionally fulfilled.

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.

Disadvantage and discrimination were minimised as staff embraced people’s human rights and individuality and were supported to develop their professionalism through appropriate training. Staff completed skills for care , and their skills were evaluated to ensure they enhanced people’s rights and staff sought valid consent.

People were 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.

People had life care plans which considered their wishes should their circumstances change or their health decline. The service was clear from the onset that this model of support had its limitations and whilst people’s support could be modified and there had been an increase in 1-1 hours,the physical environments made it more difficult to make substantial adaptations. It was recognised by family that people might have to move if the service could no longer meet their needs but through careful planning and review hopefully this could be reduced and distress minimised as Thornage Hall faced an ageing population.