Thornton Hall & Lodge

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 good. At this inspection the rating has remained the same. This meant people were safe and protected from avoidable harm.

This service scored 69 (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. Safety events such as accidents and incidents were reported in a timely way and appropriate investigations took place to identify the cause and any learning to help reduce re-occurrences.

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 recognised when people’s needs changed and made appropriate referrals to other services such as dieticians and community nursing teams. People were supported to attend appointments such as with their GP, dentist and hospital appointments. People’s care plans were updated to include any advice and guidance following appointments.

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. Managers and staff understood their responsibilities for protecting people from harm and abuse. Safeguarding concerns were recognised and referred onto the relevant agency without delay and immediate action was taken to safeguard people from further risk of harm. The principles of The Mental Capacity Act 2005 were followed to ensure people were not unlawfully being deprived of their liberty and any conditions were reviewed.

The provider worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Risks to people were assessed, monitored, managed and regularly reviewed. Measures to minimise the risk of harm to people were clearly set out in their care plan with a focus on enabling people to do the things that mattered to them. For example, guidance was in place to enable a person to safely access the garden, something they particularly enjoyed but due to safety concerns were unable to do so independently. Risks associated with aspects of people’s care such as falls, malnutrition and dehydration were routinely monitored to ensure timely intervention should the person’s condition deteriorate and require further risk management to prevent deteriorating health.

The provider detected and controlled potential risks in the environment. They made sure equipment, facilities and technology supported the delivery of safe care. Safety checks were completed at the required intervals on equipment and utilities such as hoists, baths, gas, electricity, fire and water systems. Fire exits and firefighting equipment were clearly signed and free from obstructions. There was a continuity plan in place for managing environmental emergencies such as breakdown of utilities and technology.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. There were sufficient staff with the right skills and experience deployed across the home to meet people’s needs and keep them safe. Staff received the training and support required for their role. New staff completed an induction programme, and all staff completed an ongoing programme of training specific to their role and people’s needs. Support for staff was provided through regular supervision meetings and yearly appraisals. Safe recruitment processes were followed to ensure staff were fit and suitable for the role. A series of pre-employment checks including a check with the Disclosure and Barring Service (DBS) were completed prior to an offer of employment being made.

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. Some parts of the home were unclean and unhygienic increasing the risk of the spread of infection. For example, walls, floors and cupboards in communal kitchenettes were stained with a build-up of food debris and spillages and items such as hairbrushes were stored in kitchen drawers amongst kitchen utensils. Dining chairs were also stained with a build-up of food debris and spillages. Recent infection prevention and control (IPC) checks and audits failed to identify the IPC concerns we found. Managers responded immediately after we raised our concerns with them, a deep clean of kitchenettes and dining chairs was completed. Following the site visit we received assurances confirming IPC processes had been strengthened to ensure they were more effective. However, other areas of the home including people’s bedrooms, corridors, bathrooms and the main kitchen were clean and hygienic. Stocks of PPE were plentiful and used and disposed of safely.

The provider did not always make sure medicines and treatments were safe and met people’s needs, capacities and preferences. Records to guide staff on the safe use of medicines prescribed for people to be given when required (PRN) were not in place for some people, therefore, we could not be assured they were used safely. Eye drops prescribed for 2 people with an expiry date when opened did not display the date when they were opened increasing the risk of them becoming ineffective. However, people’s care plans included a section detailing their prescribed medicines, known allergies and administration preferences. Medicines were kept secure and administered by suitably trained and competent staff. Medicine policies and best practice guidance was available as a reference for staff.