Thorn Springs

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last inspection we rated this key question requires good. At this inspection the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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 had a proactive and positive culture of safety based on openness and honesty. A learning culture was promoted at the service in ways such as staff handovers and meetings. The registered manager reviewed incidents and accidents to see where lessons could be learned. People’s care plans and risk assessments were updated based on these reviews. The registered manager had learnt lessons since our last inspection and now effectively used systems to monitor trends and see where improvements to the service could be made. Any learning was made clear to staff on the system they used to access people’s care plans and records. A relative told us, ‘‘[Family member] will often refuse their care and when this happens, I know the staff team discuss this and try and make things better. [Registered manager] always asks me for my input to so I would say we are all always learning together.’’

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Staff contacted professionals such as GP’s or speech and language therapists if people needed support. If professionals gave advice that needed to be followed, this was communicated and shared with the staff team. Professionals told us staff were knowledgeable and shared information when people needed to use different services to help ensure they were supported safely. One person told us, ‘‘[Professional] visits the service once a week to see how I am and if I ever need to go somewhere for an appointment staff come with me to make sure, I am okay.’’ A relative said, ‘‘[Staff] recognise if [family member] is feeling unwell and will let us know. They assure us about what is happening and always go with them to appointments to help them get their views across.’’

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. People and their relatives told us they/ their family member were safe living at the service. Staff were trained in safeguarding and knew what signs may indicate potential abuse and how to report concerns to external partners such as the local authority or CQC. Safeguarding concerns were reported, and any actions were taken seriously by the management and staff team. One person said, ‘‘I 100% feel safe living here and have not had any accidents because the staff are always there.’’ Another person showed us how safe they felt by approaching staff members and asking them for support on a regular basis when they felt unhappy. A relative told us, ‘‘[Family member] is safe and is never left alone for more than 10 minutes. The staff are good with this.’’

The provider worked well with people to understand and manage risks. Staff provided care that enabled people to do the things that mattered to them. Risk assessments and care plans were detailed and gave good guidance about how to support people to take risks safely. Staff knew how to keep people safe and risk assessments and care plans were focused on helping people improve their health and independence. We observed staff supporting people to use equipment such as hoists safely. People and their relatives were asked to discuss care plans and risk assessments regularly. A person told us, ‘‘[Staff] know what they are up to and will always make sure I have [piece of equipment] with me if I want to walk around by myself.’’ A relative told us, ‘‘[Staff] make the best effort they can to keep [family member] safe but also enable them to do what they want by themselves.’’

The provider detected and managed all potential risks in the care environment. The environment was safe. Staff kept equipment people used safe and in good working order and carried out checks of the building to help make sure it was safe. Fire safety risks were understood by staff and well managed. One person said, ‘‘The place looks like a hotel and fit for a king. Staff are always busy making sure the place looks good.’’ A relative told us, ‘‘[Family member’s] equipment is checked regularly and staff will report any concerns to it gets fixed quickly if need be.’’

The provider did not always make sure staff deployment was effective. There were several times of day when people went for extended periods of time without meaningful engagement from staff. Staff told us that sometimes shifts could be very busy and they only had time to support people with personal care or making sure they had a drink and something to eat. They told us it could be more difficult to spend meaningful time and chat with people for example. The registered manager and management team took our feedback seriously and evidenced how they would continue to review staffing levels at key times of the day to support both people and the staff team.

However, there were enough staff to support people with their needs such as personal care and eating and drinking. People and relative feedback confirmed this. Staff told us there were enough staff to support people safely. Staff were knowledgeable about most areas they had training in such as moving and handling and supporting people in line with the MCA. The provider recruited potential new staff safely in line with legislation. One person said, ‘‘[Staff] are always about and come and check on me day and night. They make sure I am alright.’’ A relative told us, ‘‘Whenever we go to visit, we see the same staff faces and never have an issue finding anyone if we need to.’’

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff were trained in IPC and told us they had the necessary equipment to keep the service clean. We observed the service to be visibly clean. Staff whose role was to keep the service clean took pride in their work and knew how important it was for people’s home to be kept clean. Audits and checks were in place to monitor the cleanliness of the service and the effectiveness of the IPC measures in place. A person told us, ‘‘[Staff who clean the service] are so busy but are so friendly and always say hello as they go about their day. The place is sparkling.’’

The provider made sure that medicines and treatments were safe and met people’s needs, capacities, and preferences. All areas of medicines administration were safe. People received their medicines on time and staff knew how people liked to be supported. Staff were trained to administer medicines and had their competency to do so checked regularly. Audits were effective in monitoring and making sure medicines were being administered correctly. Protocols were in place to guide staff when people may need to be administered medicines which they did not take on a regular basis. One relative told us, ‘‘[Family member’s] medicines are quite complex and I am always made aware if there are any changes to them. I think the staff do a good job of managing it all and there has never been a problem.’’