Thorndene Residential Care Home

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 assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 62 (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. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The management team had made improvements to their systems and processes and had taken action to learn lessons when things went wrong. Accidents and incidents were reviewed and corrective action taken to reduce recurrences. The management team included the wider staff team in reviewing incidents to ensure they understood what needed to improve.

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. The electronic care planning system could generate information to be used when people transferred between services. Details of people’s medicine administration also accompanied them, providing a detailed reflection of people’s current care needs.

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. The provider shared concerns quickly and appropriately. Since our last assessment, improvements to the management systems meant that a safeguarding record was now maintained. This showed safeguarding concerns had been raised appropriately. Staff confirmed their understanding of the safeguarding process and knew what action to take if they suspected abuse. One staff member said, “If I had any concerns I would inform the manager immediately.” Staff were confident the management team would take appropriate actions to keep people safe.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. The provider had taken action to ensure improvements were made when supporting people to manage risks associated with their care. Risk assessments in place had improved and contained relevant, up to date information and clear guidance to support people safely.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care. Some areas of the home still required maintenance and upgrading to ensure they were safe. Some areas of the home remain in need of refurbishment to maintain a safe and comfortable environment. There was an environmental action plan in place, however, not all entries had a timescale for completion. We found some large items of furniture had not been securely attached to the walls to prevent them tipping over. The provider took actions to address this.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always work together well to provide safe care that met people’s individual needs. During our assessment we observed there to be enough staff to respond to people in a timely way. However, people and relatives informed us that this was not always the case and raised concerns about staffing levels. One person said, “There’s not enough staff, if 2 carers take someone to the toilet in a hoist, we are left alone in the TV lounge.” We raised these concerns with the management team who told us they would take action to address them. Staff told us there were enough staff working with them to support people in line with their needs. Staff told up they received appropriate training and support to carry out their role effectively.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading or share concerns with appropriate agencies promptly. Since our last assessment improvements had been made in relation to infection prevention and control. However, areas of the home remained in need of refurbishment and were difficult to clean effectively. The provider had an action plan in place to address the refurbishment of the service.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. We found 1 person had been prescribed medication in the form of a patch, but documentation showed this had not been rotated in line with recommendations. The management team took appropriate action to address this and implemented an updated document. We also found medicines were not always stored in accordance with manufacturers guidance. Temperatures of storage facilities were taken daily but sometimes recorded above recommendations. Improvements had been noted in relation to medicines prescribed on an ‘as and when’ required basis, often known as PRN. PRN protocols were in place to ensure these medicines were administered safely.