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Independent Clinical Services Limited Good Also known as Thornbury Community Services

Inspection Summary

Overall summary & rating


Updated 2 September 2016

Independent Clinical Services trade as Thornbury Community Services, a nationwide agency providing commissioned care services with an office in the Long Ashton area of Bristol. This report focuses on the community care that TCS provides to people in their own homes. Thornbury Community Services (TCS) supply registered nurses and carers to Clinical Commissioning Groups (CCGs), case managers and private individuals providing care for clinically complex patients in their own homes. People have conditions such as acquired brain injuries, spinal injuries, paediatric and neurological conditions and require complex and high-intensity care. TCS provide community care for over 100 people around the U.K. and employ over 600 staff.

This provider was given two days’ notice of this inspection. This was because they provide care in the community and we wanted to be able to speak with some people using the service. The inspection took place on 23 and 24 March and 6 April when we looked at records in the office and spoke with the registered manager. We made telephone calls to staff and people using the service around the country on 15, 19 and 20 April. We made further phone calls on 17 and 18 May.

There is a registered manager in post. 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 2008 and associated Regulations about how the service is run.

There was a strong emphasis on respecting people’s choices, and supporting them to achieve their wishes and ambitions. The provider ensured there were no barriers in place which would prevent people from achieving their ambitions. Relatives said the family was considered in all aspects of care planning, and they were involved in regular review meetings.

The risks of abuse to people were reduced because there was an effective recruitment and selection process in place. Staff were able to demonstrate a good understanding of how to recognise and report abuse. There were systems in place to ensure that risks to people’s safety and wellbeing were identified and addressed.

People received a service that was based on their needs and wishes. A bespoke care team supported each person, which meant staff knew people very well. Care plans were personalised and contained detailed information about the support people needed. Staff were specifically trained according to the needs of the person. Staff competencies were assessed annually, or when there were any changes.

Review meetings were held regularly and people were phoned as well, to ensure the support was meeting their needs. The service was flexible and responded to people’s requests where possible. Health and social care professionals were regularly involved in people’s care to ensure they received the right care and treatment.

Relatives spoke highly of the quality of care given by carers. They said they trusted the carers to have the skills to keep them safe. People had positive relationships with their carers. Nobody expressed any concerns about any of the care provided. People received their medicines on time and in a safe way.

The provider learnt from accidents, incidents and complaints. They investigated these thoroughly and made changes where necessary. The provider gave us information about one instance when they did not have a complete oversight of a situation, and introduced additional training for staff and other changes to reduce the likelihood of a similar situation occurring.

Environmental risk assessments were completed for every new person using the service. This included checks to ensure the property was safe with adequate access, heating and lighting.

Inspection areas



Updated 2 September 2016

The service was safe.

The risks of abuse to people were reduced because there was an effective recruitment and selection process in place.

People received their medicines on time and in a safe way.

The provider had completed comprehensive risk assessments to help ensure people�s safety. Staff were aware of the risks people faced.



Updated 2 September 2016

The service was very effective.

Relatives praised the care and support people received. People received highly specialised, personalised care.

Families were supported as well as the person receiving care.

Carers received specialised training which enabled them to feel confident in meeting people�s needs. Staff told us their training was excellent.

Staff recognised changes in people�s health, sought professional advice appropriately and followed that advice.



Updated 2 September 2016

The service was caring.

People�s relationships with carers were strong, considerate and supportive.

Relatives said carers were caring and compassionate and treated people with dignity and respect.

Carers spoke confidently about people�s specific needs and how they liked to be supported. They protected people�s privacy and supported them sensitively with their personal care needs.



Updated 2 September 2016

The service was very responsive.

Staff provided exceptional care and support which enabled people to achieve their ambitions. People told us the service was outstanding.

People�s needs were assessed before their care commenced and care plans were regularly reviewed and updated as people�s needs changed.

People received individualised, personalised care and support to meet their needs.

People were supported to express their views of the service they received. Most people rated the service as excellent or above average.

Relatives knew how to raise concerns and complaints. Any concerns or complaints they raised were investigated and changes were made if necessary.



Updated 2 September 2016

The service was well-led.

The provider was forward-thinking and continually investing in systems which would benefit people using the service.

Carers were proud to work for the provider and had a good understanding of the values of the service.

There were effective systems in place to assure quality and identify any potential improvements to the service.