Town Thorns Care Centre

Updated 8 June 2023

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

Three inspectors, a specialist nurse advisor and an Expert by Experience completed this inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Town Thorns Care Centre 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. Town Thorns Care Centre is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We sought feedback from Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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 11 people and 11 relatives about their experience of the care provided. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with 16 members of staff including the registered manager, the head of care, the auxiliary service manager, a nurse, 3 house leads, 5 care assistants, the housekeeping team leader, an activities co-ordinator, the head chef and an apprentice chef. We also spoke with 2 external healthcare professionals.

We reviewed a range of records. This included 5 people's care records in full and multiple medicine records. We looked at 2 staff files in relation to recruitment. A variety of records relating to the management of the service were also reviewed.

Updated 8 June 2023

About the service

Town Thorns Care Centre is a care home that provides personal and nursing care to up to 66 people. The home provides care and support to younger and older adults, some of whom are living with a physical disability, a sensory impairment and/or dementia. At the time of our inspection there were 49 people using the service.

Town Thorns Care Centre accommodates people in a large, refurbished building which is divided into 4 separate units. Each unit has a variety of communal spaces such as lounge areas and dining areas. At the heart of the home there is a multi-functional space for everyone to use which includes a café, hairdressers, and a shop. There had been recent improvements to the outside space where people could now benefit from landscaped gardens and a walkway around the home.

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

The home had been through a programme of change prior to our inspection visit. The registered manager and the head of care had spent a significant amount of time transferring care records onto an electronic system, managing an extensive refurbishment programme, and changing their model of care internally by re-structuring how they delivered nursing care more holistically. Because of this, some of the providers systems and processes had not been operated effectively to ensure records always supported the good practices within the home. Audits had not always identified gaps in risk monitoring charts.

Despite this, people and relatives told us the home had a good management structure and staff felt valued. There was an open culture of learning within the home. The registered manager had a service improvement plan which continually monitored the service. Where actions had been identified at this inspection, they were added to the improvement plan for completion in a timely way.

People told us they felt protected from the risk of abuse. Staff were trained in safeguarding adults and understood their responsibilities to identify and report any concerns. People told us they were supported by staff who treated them with kindness and compassion. There was a strong visible person-centred culture where staff were motivated to provide high quality care. Staff understood the importance of seeing people as individuals with their own preferences and personalities.

Staff received an induction when they started working at the home. The induction included working alongside experienced members of staff in order to learn people's individual care preferences. Staff had completed the provider's training programme and people told us staff were well trained.

Overall, there were enough staff to provide safe care and treatment. We saw, and people told us, staff responded to their needs in a timely way. The home was using a high number of temporary staff supplied through an agency whilst undergoing a recruitment campaign.

People were offered opportunities to engage in a wide range of activities. Activities were often held in the multifunctional communal lounge, in the centre of the home which gave people the opportunity to socialise with people who might reside in other areas of the home. People were offered regular trips outside the home, so they maintained a sense of belonging within the wider community of the local area.

People's needs were assessed before they moved into the home so their care could be planned based on their needs, wishes and choices. Staff understood people’s communication needs and gave people information in a way they would understand. Care plans were focussed on the person’s whole life and detailed important information about their needs, preferences and backgrounds, and were regularly reviewed.

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 health needs were met. Staff supported people to maintain their health through regular appointments or timely referrals with healthcare professionals. The GP visited the home twice a week, but staff told us they would not hesitate to refer any healthcare concerns to the GP outside their scheduled visits if this was necessary.

People and relatives were generally positive about the food provided. People were provided with a choice of meal options and drinks were always available. The chef catered for people’s preferences and dietary needs.

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 this service was good (published 16 December 2017).

Why we inspected

The inspection was prompted in part due to concerns received about medicines management. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe section of this full report.

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.

The overall rating for the service remains good based on the findings of this inspection.

Follow up

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