Thorn Park Care Home (‘Thorn Park’) is a residential care home for 36 older people who may be living with dementia and have a range of needs. We inspected on the 19, 20 and 23 April 2018. On the days we inspected, 34 people were living at the service.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good.

People felt safe at the home and with the staff who supported them. There were systems and processes in place to minimise risks to people. These included a robust recruitment process and making sure staff knew how to recognise and report abuse. There were adequate numbers of staff available to meet people’s needs in a timely manner. People received their medicines as prescribed in a caring way.

People received effective care from staff who had the skills and knowledge to meet their needs. Staff monitored people’s health and well-being and made sure they had access to other healthcare professionals according to their individual needs. People’s food and drinks were monitored to ensure people were kept healthy. Falls were reduced by the service’s focus on ensuring everyone’s sodium levels were monitored.

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.

People were supported by staff who were kind and caring. Where people found it difficult to express themselves, staff showed patience and understanding. Alternative methods of communication, family and advocates were utilised to help staff understand people’s needs when verbal communication was not easy for them.

The service was responsive to people’s needs and they were able to make choices about their day to day routines. People had access to a range of organised and informal activities which provided them with mental and social stimulation.

People could be confident that at the end of their lives they would be cared for with kindness and compassion and their comfort would be maintained. Staff worked well with other organisations to make sure high standards of care was provided and people received the support and treatment they wished for at the end of their lives.

People said they would feel comfortable making a complaint and were confident action would be taken to address their concerns. The registered manager and provider treated complaints as an opportunity to learn and improve.

The home was well led by an experienced registered manager and management team. The provider had systems in place to monitor the quality of the service, seek people’s views and make on-going improvements.

Further information is in the detailed findings below

The inspection took place on 5 and 6 January 2016 and was unannounced. Thorn Park Care Home provides care and accommodation for up to 36 older people, some of whom are living with dementia. On the day of the inspection 35 people lived at the home. The providers own other services in the Plymouth area.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

One person said; “It’s been lovely to be able to give a testament back to say what a lovely wonderful place this is. I am so please I came here.”

People were busy and were enjoying the company of the staff. There was a calm and relaxed atmosphere within the service. Comments included; “Staff are kind and caring.” A survey returned to the home said; “With the constant care and love given she is still with us.” People said they were happy living at the service.

People, relatives and visiting professionals were happy with the care the staff provided. They agreed staff had the skills and knowledgeable to meet people’s needs. People were encouraged and supported to make decisions and choices whenever possible in their day to day lives.

People had their privacy and dignity maintained. Staff were observed supporting people with patience and kindness.

People were better protected from harm as staff had completed safeguarding of vulnerable adults training and had the knowledge on how to report any concerns and what action they would take to protect people. Staff were confident any incidents or allegations would be fully investigated. The registered manager had sought and acted on advice where they thought people’s freedom was being restricted. Applications were made and advice sought to help safeguard people and respect their human rights

People were protected by safe recruitment procedures. Staff were supported with an induction and ongoing training programme to develop their skills and staff competency was assessed. Everyone we spoke with felt there were sufficient staff on duty.

People received visits from healthcare professionals, for example GPs and district nurses, to ensure they received appropriate care and treatment to meet their health care needs. Professionals confirmed staff followed the guidance they provided. This ensured people received the care they needed to remain safe and well, for example people had regular visits by district nurses to change dressings. A relative survey recorded; “His health and mentality has improved since he entered Thorn Park.”

People’s medicines were managed safely. Medicines were managed, stored, and disposed of safely. Senior staff administered medicines and had received training and confirmed they understood the importance of safe administration and management of medicines.

People who did not have capacity to make decisions for themselves were supported by staff to make sure their legal rights were protected and staff worked with other professionals in their best interest.

People were supported to maintain a healthy balanced diet. People told us they enjoyed their meals, there was plenty of it and we observed people were not rushed.

People’s care records were computerised and of a good standard. People’s care records were comprehensive and detailed people’s preferences.

People’s risks were considered, well-managed and regularly reviewed to keep people safe. Where possible, people had choice and control over their lives and were supported to engage in activities within the home. Records were updated to reflect people’s changing needs. People and their families were involved in the planning of their care.

People and staff described the registered manager as approachable, available an

We met and spoke to most of the people who used services, we spoke to five relatives, talked with the staff on duty and checked the provider's records. We also spoke to four visiting professionals and one relative told us, “The staff have great empathy”.

We saw people's privacy and dignity were respected and staff were helpful. Comments from people who lived in the care home included "A lovely place to live”.

We saw and heard staff speak to people in a way that demonstrated a good understanding of people's choices and preferences. We looked in detail at the care four of the people using the service received. We spoke to staff about the care given, looked at records related to these people, met with them, and observed staff working with them.

We observed that people were supported to make decisions about their lives and be as independent as possible. We saw that people's care records described their needs and how those needs were met.

Staff we spoke with were clear about the actions they would take should they have any concerns about people's welfare.

During our inspection we saw sufficient staff on duty to meet the needs of people living in the home.

As part of the quality monitoring system, people who lived in the home, and their relatives, were sent surveys to complete, that asked their views of the home.