Archived: Thorpe House Nursing Home

Updated 31 January 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This unannounced comprehensive inspection took place on 11 December 2017 by one inspector, a specialist nurse advisor and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

This was the third comprehensive inspection since October 2014. The last comprehensive inspection was 13 October 2016 where we rated the service as Requires Improvement; there were two breaches of the regulations. We asked the provider for an action plan to explain how they were going to become compliant. We received the action plans that demonstrated that the service would be complaint with all the regulations by 31 March 2017. We contacted the health and social care commissioners who monitor the care and support of people receiving care from Thorpe House Nursing Home who told us they had visited the home in May 2017. They carried out an audit where the service scored 92%; they told us they did not have any concerns about the home.

We used information the provider sent us in the Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We checked the information we held about the service including statutory notifications. A notification is information about important events which the provider is required to send us by law.

During this inspection we spoke with six people using the service and four relatives. Most people were not able to speak due to their dementia, we spent time observing their care and how staff interacted with them. We also spoke with eight members of staff including the registered manager, the provider, the compliance officer, two nurses, two care staff and kitchen staff.

We looked at the care records for four people who used the service and five medication records. We also examined other records relating to the management and running of the service. These included five staff recruitment files, training records, supervisions and appraisals. We looked at the staff rotas, complaints, incidents and accident reports and quality monitoring audits.

Updated 31 January 2018

This inspection took place on 11 December 2017 and was unannounced.

This was the third comprehensive inspection carried out at Thorpe House Nursing Home.

Thorpe House Nursing 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. The care home accommodates up to 50 people in one adapted building. On the day of our visit, there were 43 people using the service.

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 and associated Regulations about how the service is run.

Following the last inspection in October 2016 we asked the provider to complete an action plan to show how they were going to become compliant with the regulations relating to staffing and person centred care. During this inspection we found that the action plans had been implemented and had driven improvements in all areas of care people received. There were enough staff deployed to meet people’s needs and care was provided in a person centred way.

The registered manager provided an open and learning culture which involved staff, people who used the service and their relatives to feedback about the service and have their comments responded to. The registered manager had used people’s experiences to analyse the quality of their care and had changed the way staff provided care and monitored the quality of the service closely.

Staff understood their roles and responsibilities to safeguard people from the risk of harm. Risk assessments were in place and were reviewed regularly; people received their care as planned to mitigate their assessed risks.

Staffing levels ensured people's care and support needs were safely met. Safe recruitment processes were in place. People received care from staff who had received training and support to carry out their roles. People were supported to have enough to eat and drink to maintain their health and well-being.

People were supported to access relevant health and social care professionals. There were systems in place to manage medicines in a safe way.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Staff demonstrated an understanding of the Mental Capacity Act, 2005 (MCA). Staff gained people's consent before providing personal care. People were involved in the planning of their care which was person centred and updated regularly.

People were encouraged to make decisions about how their care was provided and their privacy and dignity were protected and promoted. People had developed positive relationships with staff. Staff had a good understanding of people's needs and preferences.

People were listened to, their views were acknowledged and acted upon, and care and support was delivered in the way that people chose and preferred.

People using the service and their relatives knew how to raise a concern or make a complaint. There was a complaints system in place and people were confident that any complaints would be responded to appropriately.

We made a recommendation that the provider seeks advice on how to improve communication with people who have a sensory loss.