Thorley House Residential Care Home

Updated 5 March 2021

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC's response to the coronavirus pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

This inspection took place on 16 February 2021 and was announced.

Updated 5 March 2021

We carried out an inspection of Thorley House Residential Care Home on the 14 and 15 November 2018, the first day of inspection was unannounced. This was the first time the home had been inspected since it re-registered with the Care Quality Commission in November 2017, due to a change in ownership.

Thorley House Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Thorley House Residential Care Home is situated in a quiet residential area of Hindley, Wigan and is registered to provide personal care and accommodation for 40 people. At the time of this inspection 40 people were living at the home.

The service had a registered manager. 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 home had a clear management structure in place. The registered manager was supported by a deputy manager, as well as the area manager, who used to run the home, so was familiar with the people and staff. People, their relatives and staff spoke positively about the running of the home, telling us both managers were approachable, willing to ‘muck in’ and they had a visible presence throughout the home.

People told us they felt safe living at Thorley House and thought there were enough staff to provide safe care and respond to their requests for support. Relatives were also complimentary, reporting their family members were well cared for and their needs met. Both people and relatives told us they would feel comfortable approaching a staff member or the registered manager should they have any concerns or complaints, but had not yet had cause to.

The home had appropriate safeguarding policies and reporting procedures in place and had submitted notifications to the local authority and CQC as required. Staff had all received training in safeguarding, which was regularly refreshed. Staff were aware of the different types of abuse and how to report concerns.

The home had effective infection control and cleaning procedures in place. Regular monitoring of the environment was completed and checklists used to ensure cleaning tasks had been completed to required standards. Staff wore personal protective equipment (PPE) to prevent the spread of infection and toilets and bathrooms contained hand hygiene equipment and guidance.

Medicines were stored, handled and administered safely and effectively. Documentation had been completed correctly and consistently. All medicines checked had been administered as prescribed. Staff responsible for administering medicines had been trained and had their competency assessed. Audits were completed weekly and monthly to ensure standards had been maintained and that any shortfalls or issues were addressed.

We found care files contained detailed risk assessments, which had been regularly reviewed to reflect people’s changing needs. This ensured staff had the necessary information to help minimise risks to people living at the home.

People were supported to have maximum 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 practice. All staff members we spoke with demonstrated a good knowledge and understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), which is used when someone needs to be deprived of their liberty in their best interest. We saw the service was working within the principles of the MCA and had followed the correct procedures when making DoLS applications.

Staff spoke positively about the support and training provided. Staff completed an induction training programme upon commencing employment and on-going training was provided, both e-learning and face to face, to ensure skills and knowledge remained up to date. Supervision was completed to provide staff with an opportunity to discuss their roles, any areas for improvement and future goals.

People were happy with the choice of meals provided and told us they received enough to eat and drink. People were involved in decision making around what they ate, with menus discussed at resident meetings and changes made following feedback. Special dietary requirements were catered for, such as soft meals or thickened fluids. Food and fluid charts had been used where people had specific nutritional or hydration needs, with clear guidance in place for staff to follow.

People told us staff were kind, caring and treated them with dignity and respect. Staff had taken time to get to know people, which was evident in the interactions we observed. People were comfortable in the company of staff members and engaged in friendly conversation and ‘banter’, laughing and joking as they received support.

Care files contained personalised information about the people who used the service and how they wished to be supported and cared for. Each file contained concise, yet informative care plans and risk assessments, which helped ensure people’s needs were being met and their safety maintained. People and their relatives told us they were involved in care planning and reviews.

Peoples’ social and recreational needs were met through an activities programme, facilitated by an enthusiastic co-ordinator. We saw a mix of activities were organised throughout the week which catered for all interests and abilities along with regular outings and visits from entertainers.

The home had a range of systems and procedures in place to monitor the quality and effectiveness of the service. Audits were completed on a daily, weekly, monthly or quarterly basis, depending on the area being assessed and covered a wide range of areas including medication, meal times, infection control, accidents and incidents and health and safety. Provider level audits had also been completed on a monthly basis, to provide further oversight of all aspects of service provision.