Thornbury Villa

Updated 7 October 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team was made up of one inspector and one assistant inspector.

Service and service type

Thornbury Villa is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Thornbury Villa is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with the provider who also was the nominated individual. They are responsible for supervising the management of the service. We spoke with the manager and five care staff. We also spoke with three people who used the service and three relatives. To help us assess and understand how people’s care needs were being met we reviewed care records. This included medicine records and a variety of records relating to the management and governance of the service, which included recruitment and training records. We observed how people were being cared for and looked around the service observing infection prevention control practices.

After the inspection

We continued to seek clarification to validate evidence found. We looked at records sent to us after the inspection.

Updated 7 October 2022

About the service

Thornbury Villa is a residential care home that provides personal care for older people. Thornbury Villa is registered to accommodate 14 people, at the time of the inspection 11 people lived at the service.

People’s experience of using this service and what we found

People told us they felt safe and were happy with the care and support they received. People were protected from avoidable harm and abuse. There were sufficient numbers of staff to meet people’s needs. Recruitment processes ensured new staff were suitable for their role. Staff enjoyed their job roles and felt supported by the management team and had the skills to meet people’s needs.

People received their medicines as prescribed. Risks to people were assessed and known. Staff knew people’s dietary and health needs and provided appropriate care and support. Staff followed safe infection prevention and control practices.

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. People’s dignity and privacy was respected. People told us staff were caring and supported them to maintain their independence. People had access to a range of activities and were supported to maintain contact with their family and friends.

The provider, manager and staff were clear about their roles and responsibilities. People’s views about the service were sought and listened to. Checks were completed to ensure standards of quality and safety were being maintained during a transition from a paper-based system to an electronic record and governance system.

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 the service under the previous provider was outstanding, published on 7 January 2020.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.