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Thornfield Care Home - Lymington Good


Inspection carried out on 29 June 2017

During a routine inspection

Thornfield Care Home is owned by Mr and Mrs Poordil who are throughout this report referred to as the provider. The home is located in a residential area, approximately one mile from the centre of Lymington. It can accommodate up to 17 people. The accommodation is arranged over two floors with a stair lift available to access the upper floor. On the ground floor there is an open plan living/ dining area from which there is access to the kitchen, laundry and the office. Four of the rooms were shared rooms. There is a large, mature garden with seating areas. The home does not provide nursing care. There were 16 people living in the home when we inspected, some of whom were living with dementia.

At the last inspection in April 2015, the service was rated good. At this inspection we found that the service remained good.

The service had a registered manager who was also the registered provider. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

Staff had received training in safeguarding adults, and had a good understanding of the signs of abuse and neglect.

Safe recruitment practices were followed and there were sufficient numbers of experienced staff to meet people’s needs.

People were supported by a staff team that received the training, supervision and support that they needed to provide people with care and support that met people's needs.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this in practice.

Improvements were planned to update aspects of the premises and make the design and layout of the home more suitable for people living with dementia.

People told us the food was tasty and that they were supported to have enough to eat and drink.

People told us they were supported by staff that were kind and caring and that they were treated with dignity and respect.

Care plans contained the information needed to support staff to provide people’s care in a manner that was responsive to their individual needs.

People were supported to take part in activities which they told us they enjoyed.

People spoke positively about how well organised and managed the service was.

There were systems in place to assess and monitor the quality and safety of the service and to ensure people were receiving appropriate support.

Inspection carried out on 13 April 2015

During a routine inspection

Thornfield Care Home is registered to provide accommodation and support for up to 17 older people who may also be living with dementia. This home is not registered to provide nursing care.

On the day of our visit 17 people were living at the home. The home has nine single and four double occupancy rooms. The home is situated within walking distance of local facilities in the town centre and surrounding area. The home has one large living room / dining area and kitchen. There is a stair lift to the first floor. The home has a well maintained garden and a patio area that people are actively encouraged to use.

The inspection on 13 April 2015 was unannounced.

There was a registered manager at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

Staff understood the needs of the people and care was provided with kindness and compassion. People, relatives and health care professionals told us they were very happy with the care and described the service as excellent. A visiting GP told us, “I have the utmost confidence that staff provide excellent care. I have no concerns at all regarding anyone living there. The home always contact us if they are unsure or need advice”.

People were supported to take part in activities they had chosen. One person said, “I love living here. The staff are very kind and look after all of us very well”.

Staff were appropriately trained and skilled to ensure the care delivered to people was safe and effective. They all received a thorough induction when they started work at the home and fully understood their roles and responsibilities.

The registered manager assessed and monitored the quality of care consistently involving people, relatives and professionals. Care plans were reviewed regularly and people’s support was personalised and tailored to their individual needs. Each person and every relative told us they were asked for feedback and encouraged to voice their opinions about the quality of care provided.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Three people living at the home were currently subject to a DoLS. The manager understood when an application should be made and how to submit one. They were aware of a recent Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty.

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 to ensure any decisions were made in the person’s best interests.

Staff talked to people in a friendly and respectful manner. People told us staff had developed good relationships with them and were attentive to their individual needs.

Staff respected people’s privacy and dignity at all times and interacted with people in a caring and professional manner.

People told us they felt staff were always kind and respectful to them. Staff told us they were encouraged to raise any concerns about possible abuse. One member of staff said, “We talk about abuse all the time. How to recognise it and what to do if we thought someone was being abused. I know if we have concerns we can speak to the manager and she would report it”.

People and relatives knew how to make a complaint if they needed to. The complaints procedure was displayed in the home. It included information about how to contact the ombudsman, if they were not satisfied with how the service responded to any complaint. There was also information about how to contact the Care Quality Commission (CQC).

The home routinely listened and learned from people and visitor experiences through annual resident/ relatives’ survey. The surveys gained the views of people living at the home, their relatives and visiting health and social care professionals and were used to monitor and where necessary improve the service.

Inspection carried out on 29 August 2013

During a routine inspection

We found that care plans contained details of the aims and objectives to maintain levels of independence and instructions for staff to continue to give time to people so that they felt comfortable at the home. Daily care notes were updated with the care given and details of the moods and feelings of the people living at the home. One relative we spoke with said: “I visit most days and I know that my relative is well cared for. I am relaxed and very confident that the care I see when I am here continues when I am not here”.

People were provided with a choice of suitable and nutritious food and drink. We saw a copy of the menu which was nutritionally balanced and varied with two choices of meal each day. The registered manager told us that some people had asked for different meals to be added to the menu. One person who used the service told us: “We are always given two choices of food at lunch time. There is other food available if I changed my mind”.

Appropriate checks were undertaken before care workers began work. We looked at the personnel records for four care workers. These confirmed that they had been interviewed, that references had been requested and that the provider had completed appropriate background checks before they started work at the home.

The registered manager told us how she ensured people were kept safe from harm or risk by undertaking regular audits. We saw that these audits included, for example medication, the environment and food hygiene. The registered manager said that any areas identified as needing improvement would be discussed at the staff team meetings and plans put in place to improve the service.

Inspection carried out on 28 June 2012

During a routine inspection

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We used SOFI in this inspection because Thornfield Care Home provides a service for people with dementia and many of the people using the service were not able to provide direct feedback to us about their experiences.

During the observations we saw staff interacting with people in a friendly and respectful manner. Staff took the time to respond to questions and to ask people their preferences. Staff helped people to make decisions about activities that were taking place, for example, asking people whether they wanted to go out to the garden for a walk, taking time to discuss a magazine article with one person, responding to questions and supporting people to make choices about drinks and snacks. Staff demonstrated a good understanding of people’s needs and communicated with people in different ways. Staff responded to requests for support, for example, to go to the toilet and to fix a hearing aid.

During the visit we spoke directly with two people who used the service. Both said they were well treated by the staff and that they were happy at the home. One person said they received “excellent care”. Another person told us “staff know what they’re doing and have the right skills”. Both people we spoke with said they were aware of the home’s complaints procedures and confident that any concerns they had would be resolved by the provider.

Inspection carried out on 6 March 2012

During an inspection to make sure that the improvements required had been made

During this visit we spoke with three people who live at the home, the service providers and two members of staff. Many of the people using the service were not able to verbally communicate with us. We therefore spent time during our visit observing the care and support being given and how staff interacted with people.

Two people we spoke with told us that they did feel that they were involved in their care. They said that their families were also involved and that they were confident that the provider was aware of their wishes. They said that they felt safe and secure in the home and gave positive feedback about the staff. We observed staff talking to people and asking them about their needs. Staff spoke to people in a respectful manner and listened and responded to what they said.

Inspection carried out on 21 October 2011

During a routine inspection

People we spoke with said that staff were respectful and polite. We were told how the service encouraged and supported people’s autonomy and independence as much as possible. During our visit people were observed being spoken with and supported in a friendly and respectful manner. They told us they were getting the care and support they needed and that staff treated them well. Staff were “always ready to help” and responded quickly if they asked for assistance.

People said that the food provided was good and there was always plenty to eat and drink. They said that they could have an alternative meal to the main menu if they wished. Visitors were always made to feel welcome.

People told us that they felt safe and were well cared for in the home. They felt that the staff were caring and had the qualities and skills to perform their work well. They told us that the service providers were “approachable and kind”. They said that they could raise any concerns and were confident they would be responded to appropriately.

Reports under our old system of regulation (including those from before CQC was created)