We carried out a review of the data available to us about The Thorns Retirement Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Thorns Retirement Home, you can give feedback on this service.
We found the following examples of good practice.
¿ The registered manager had ensured staff could access comprehensive and informative training in various aspects of infection control. Staff confirmed they felt confident in the training and this helped them deliver
care based on best practice.
¿ The environment and equipment had been arranged to minimise the risk of infection and was clean and clutter free.
¿ Information was gathered from visitors to help minimise the risk and spread of infection.
¿ Risk assessments were carried out to minimise the risk and spread of infection.
¿ Processes to minimise the risk of infection were carried out by staff. For example, temperature checks, safe waste disposal and increased cleaning of the home took place.
¿ Covid-19 policies and risk assessments were available and known by staff.
¿ Checks and audits were carried out on the cleanliness of the home and action taken if this was needed.
¿ Adequate handwashing facilities, infection control gel and personal protective equipment (PPE) was available to support best practice.
¿ Staff supported people to use electronic tablets and telephones to maintain contact with loved ones.
¿ People were supported to access health professional advice and maintain their well-being.
¿ The service was taking part in the whole home testing process. People at the home were supported to decide if they wanted to participate. If people were unable to make this decision for themselves, best interest discussions were held with relatives and documented.
¿ Appropriate signage was displayed throughout the home to promote best practice.
The Thorns Retirement home is a residential care home providing accommodation and personal care to older people. The service can support up to 15 people. At the time of the inspection the service was providing support to 11 people. The Thorns Retirement Home is an adapted building which has been extended. It has one communal living area, a dining area, a conservatory and an unsecured garden. Accommodation is based over two floors and there is a passenger lift in between floors for people with mobility needs.
People’s experience of using this service and what we found
People and relatives told us safety was considered and promoted. One person said, “Of course I feel safe, it is a very safe environment.” The provider was aware of the need to monitor and address risk in a timely manner. People and relatives told us they were happy with staffing arrangements at the home. Staff were aware of the importance of keeping people safe and responding to the risk of abuse. Medicines were managed safely. However, we found documentation relating to medicines was not always consistently maintained in line with good practice we have made a recommendation about this.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff had received training to enable them to understand the principles of the Mental Capacity Act 2005.
People’s health needs were monitored and addressed and there was evidence of working closely with other health and social care professionals. Everyone we spoke with agreed the staff had the appropriate skills and training required. People told us they were happy with the quality of the food provided. One person said, “They [the meals] are very good and they are not mean with the food.”
People and relatives told us there was an emphasis on providing person centred care within the home. Activities had been developed in line with people’s expressed wishes and there was great emphasis on providing varied and interesting activities to promote health and well-being. Staff had been trained to support people at the end of their lives. People and relatives praised the responsiveness of the management team and their commitment to listening and responding to feedback.
Care and support was flexible and tailored to people’s needs. People were able to have control over their preferred routines. Relatives told us they were always welcomed at the home People and relatives repeatedly told us staff were kind and caring. Observations made during the inspection confirmed this.
People, relatives, staff and health professionals repeatedly told us the service was well-led. They praised the skills and approachability of the registered manager. We saw evidence of multi-disciplinary working to ensure care was delivered in line with good practice. The registered manager was aware of their role and responsibilities and the importance of continuous improvement.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 14 March 2017).
Why we inspected
This was a planned and scheduled inspection.
Follow Up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Thorns Retirement Home on our website at www.cqc.org.uk.
The Thorns Retirement Home is situated in Hest Bank village in Lancaster. The home provides accommodation for a maximum of fifteen people who are 65 and over. Accommodation is provided in 11 singles and 2 double bedrooms over two floors. A lift is available for use between floors. The double rooms are used as singles, unless occupied by couples who want to share. En-suite facilities are available. The home is set within its own grounds, including a designated car park. At the time of the inspection visit there were nine people residing at the home.
There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
We last carried out a comprehensive inspection of the service 07 and 12 October 2015. At this inspection we rated the service as requires improvement as we identified concerns within the environment. We also found processes were not in place to ensure CQC was notified of all significant events. We carried out a focussed inspection in May 2016 to ensure all improvements had been made. We found the service had made all required improvements.
At this inspection carried out in February 2017, people and relatives spoke positively about the care delivered. People told us staffing levels were conducive to meet their needs. We observed staff being patient and spending time with people who lived at the home.
Staff treated people with kindness and compassion. We observed staff being patient with people and offering reassurance when required. People who lived at the home and relatives all commended the caring nature of the staff team. We noted there was an emphasis on promoting dignity, respect and independence for people who lived at the home.
People told us they felt safe and secure in a homely environment. Arrangements were in place to protect people from risk of abuse. Staff had knowledge of safeguarding procedures and were aware of their responsibilities for reporting any concerns.
Suitable arrangements were in place for managing and administering medicines. The registered manager carried out audits of medicines to ensure systems were being followed correctly by staff. We noted action had been taken by the registered manager when areas for improvement were identified.
Recruitment procedures were in place to ensure the suitability of staff before they were employed. Staff told us they were unable to start their employment without all the necessary checks being in place.
People’s healthcare needs were monitored and managed appropriately by the service. People told us guidance was sought in a timely manner from health professionals when appropriate. Relatives praised the ways in which people were supported to maintain good health.
Care plans were in place for people who lived at the home. Care plans covered support needs and personal wishes. People who lived at the home and relatives said they were involved in the care planning process. Plans were reviewed and updated at regular intervals and information was sought from appropriate professionals as and when required.
Feedback on the quality of food provided was extremely positive from both people who lived at the home and relatives. People were happy with the variety, quality and choice of meals available to them. People’s nutritional needs were addressed and monitored.
There was a variety of social activities on offer. The registered manager had established links with various community groups who frequented the home and provided entertainment. Cultural needs were recognised and addressed by the registered manager.
People who lived at the home praised the living standards offered at the home. The home was repeatedly described as a ‘home from home.’ Premises and equipment were appropriately maintained.
The registered manager had a training and development plan for all staff. We saw evidence staff were provided with relevant training to enable them to carry out their role.
There was an ongoing training programme to ensure all staff had received training in The Mental Capacity Act 2005 and the associated Deprivation of Liberty Standards (DoLS.) Staff we spoke with were aware of the principles should someone require being deprived of their liberty.
Feedback was routinely sought from people who lived at the home and relatives. There was a commitment from the registered manager to promote people’s independence and involve them in the way the home was managed.
The registered manager had implemented a range of assurance systems to monitor quality and effectiveness of the service provided. They fed back to the nominated individual any concerns so improvements could be made. The registered manager praised the support offered to them from the nominated individual.
The registered manager had introduced an auditing system at the home but this had not incorporated all aspects of managing the service. We have made a recommendation about this.
People who lived at the home, relatives and staff all provided positive feedback about the registered manager. Staff were positive about ways in which the service was managed. Staff described teamwork as “Good,” and said there was regular communication between senior management and staff.
This unannounced focussed inspection took place on 03 May 2016.
The Thorns Retirement Home is situated in Hest Bank village near Lancaster. The home provides accommodation for a maximum of fifteen people who are 65 and over. Accommodation is provided in 11 singles and two double bedrooms over two floors. A lift is available for use between floors. The double rooms are used as singles, unless occupied by people who want to share. Ensuite facilities are available within some of the rooms. The home is set within its own grounds and has a designated car park.
There was a registered manager in place. 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.
At the inspection we were informed the registered manager was in the process of retiring and they were inducting a new manager who was intending to start the registration process. We spoke with the manager as part of the inspection process.
There were thirteen people living at the home at the time of the inspection.
The service was last inspected on 07 and 12 October 2015. At this inspection we found the registered provider was not meeting all the fundamental standards. We identified a breach to Regulation 17 the Health and Social Care Act 2014 as the registered provider did not have systems in place to assess, monitor and improve the safety of services provided. We also identified a breach to Regulation 18 of the Care Quality Commission (Registration) Regulations 2009 as the registered provider had failed to report notifiable events to the Care Quality Commission.
Following the inspection in October 2015, we asked the registered provider to submit an action plan to show what changes they were going to make to become compliant with the appropriate regulations. The registered provider returned the action plan to demonstrate the improvements they intended to make. We used this inspection to look to see if the action plan had been completed and to ensure all fundamental standards were now being met.
At this focussed inspection carried out in May 2016, we found improvements had been made.
Highlighted environmental concerns had been actioned to promote safety of the people who lived at the home.
Systems had been implemented to ensure all notifiable incidents were relayed to the Care Quality Commission in a timely manner.
Portable appliance testing had been carried out to demonstrate that appliances used within the home were suitable for use.
An expired fire risk assessment had been reviewed and updated by an external fire safety company.
However we found evidence the risk assessment had not been reviewed by the management of The Thorns Retirement Home. Immediate action was taken by the registered provider once we had highlighted these concerns. We have made a recommendation about this.
This unannounced inspection took place on 07 and 12 October 2015.
The Thorns Retirement Home is situated in Hest Bank village near Lancaster. The home provides accommodation for a maximum of fifteen people who are 65 and over. Accommodation is provided in 11 singles and two double bedrooms over two floors. A lift is available for use between floors. The double rooms are used as singles, unless occupied by people who want to share. Ensuite facilities are available within some of the rooms. The home is set within its own grounds and has a designated car park.
There were twelve people living at the home on the day of inspection.
There was a registered manager in place. 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.
The service was last inspected on 8 January 2014. We identified no concerns at this inspection and found the provider was meeting all standards that we assessed.
At this inspection, feedback from relatives and visitors was positive and people who lived at the home spoke highly about the quality of service provision on offer. Staffing levels were conducive to meet people’s needs. We observed staff being patient with people and meeting their needs in a responsive manner.
Arrangements were in place to protect people from the risk of abuse. People told us they felt safe and secure. Staff had a sound knowledge of safeguarding and were aware of their responsibilities for reporting any concerns. However processes in place were inconsistent to ensure that all safeguarding alerts were communicated to the Care Quality Commission (CQC.)
Robust recruitment procedures were in place to ensure staff were correctly vetted before being employed.
The registered manager had suitable arrangements in place for managing medicines. Medicines were safely kept and appropriate arrangements for administering them were in place. The registered manager carried out regular audits of medicines to ensure systems in place were being followed correctly by staff.
People’s healthcare needs were monitored and referrals were made to health professionals in a timely manner when people’s health needs changed.
People were happy with the variety and choice of meals available to them. Regular snacks and drinks were available to people between meals. Mealtimes were seen as a social occasion for people who lived at the home. Relatives and visitors were made welcome and were encouraged to eat with people who lived at the home. Feedback on the quality of food provided was positive from both people who lived at the home and relatives.
Risks to people who lived at the home were sometimes appropriately managed. Systems were in place to manage people at risk of falls, people at risk of pressure ulcers and other health related conditions. However risks presented within the environment were not always appropriately managed. We noted a fire risk assessment completed by an external specialist agency for the registered provider had not been acted upon and was out of date. The registered manager also failed to identify that portable appliance testing was also out of date. We identified a hot water tap that was not temperature regulated. This placed people at risk of harm of being scalded from the hot water.
The registered provider kept a detailed log of all accidents and incidents that had occurred at the home. However during the course of the inspection we identified two serious incidents that had not been reported, as required to the Care Quality Commission.
The home provided a good array of social activities for people who lived at the home. Family members and friends were encouraged to participate in activities. Consideration was taken to ensure people who chose not to interact within groups were supported in their rooms. Cultural needs were also recognised by the registered provider.
Detailed care plans were in place for people who lived at the home. Care plans covered their support needs and personal wishes. We saw plans had been reviewed and updated at regular intervals and information was sought from appropriate professionals as and when required.
Staff were positive about their work and confirmed they were supported by the registered manager. Staff received regular training to make sure they had the skills and knowledge to meet people’s needs.
You can see what action we told the provider to take at the back of the full version of the report.
We observed staff interacting with people in a very supportive and respectful manner. This matched their related care plans. Care records were person-centred and reviewed regularly. One person told us, 'I'm very pleased with the home, the staff and the level of care I receive'.
The Thorns had effective procedures in place to safeguard people from potential abuse. We additionally observed that the home had appropriate staffing levels and staff skill mixes. Suitable systems were in place to monitor the quality of the service provided.
One person told us 'I feel like it's my home. Staff support me in ways that best suit me'. Another individual told us 'The staff are very caring and visitors can come and see me at any time'
We observed the interaction between the staff and the people who used the service. The staff were respectful of people and treated them with dignity. For example, we saw staff knocking on people's bedroom doors before entering. We also saw staff offer assistance with personal care needs in a discrete and dignified manner.
We spoke with a relative who told us 'I'm confident that the care and support provided for mum is very good and I have no concerns'.