Thornton Lodge Residential Care Home supports people with mental health needs. It is registered to provide care and accommodation for up to 36 people. The home has an accessible garden area, a range of communal rooms and a dining area. Bedrooms are available over two floors which are accessible via stairs or a lift. At the time of the inspection visit there were 35 people residing at the home.

At the last inspection, the service was rated as Good. At this inspection visit carried out in January 2018 we found the service remained Good. We found the registered provider continued to provide a very good standard of care to people who lived at the home.

Relatives and professionals we spoke with told us the service provided exceptional care. They told us people’s health needs were met and people experienced positive health outcomes. We saw evidence of holistic care being delivered. Holistic care promotes people’s physical and mental health. A registered mental health nurse was employed at the home to ensure good practice guidelines were implemented and suitable standards of care were sustained.

The registered provider had introduced health initiatives at the home to support people to have healthier lives. This included projects around diet and nutrition. People told us this had made a difference to their quality of life.

Since the last inspection, the registered provider had commenced a refurbishment programme at the home to make the home more inviting for people who lived there. This had including working with people who lived at the home to re-design the garden space to make it welcoming and interesting for people to use. We spoke with the gardener employed to make the changes. They told us the garden had made a difference to the quality of life of people who lived at the home.

We saw evidence of multi-agency working to promote effective care. Professionals praised the skills and knowledge of staff who worked at the home. They told us the home was good at meeting the needs of people with complex needs. Staff told us they were very well supported in their job and were encouraged to progress with self-development.

People, relatives and professionals spoke highly about the positive characteristics of staff. They told us that staff who worked at the home were kind and caring. We observed people being offered emotional support in a sensitive and timely manner. Privacy and dignity was routinely considered by staff. Visitors told us they were welcomed at the home at all times.

We received consistent positive feedback about the quality of food provided at the home. People were offered choices to meet their preferences and dietary needs. Drinks and snacks were accessible at all times.

People we spoke with told us they felt safe living at the home. Professionals told us staff had the appropriate skills to keep people safe. Systems were in place to safeguard people from abuse. Risks were assessed and safety of people was monitored by staff on an ongoing basis.

We reviewed accidents and incidents that had occurred at the home. We saw the registered provider was proactive and transparent when things went wrong and reflected upon the incidents so improvements could be made and lessons could be learned.

People who lived at the home, relatives and professionals praised the staffing levels at the home. They told us there were enough staff on duty to meet individual needs. Staffing levels allowed people who lived at the home to feel safe and pursue activities of their choosing.

There was an emphasis upon encouraging people who lived at the home to have active lives. Friendships and relationships were developed and nurtured both within the home and in the community. In 2017, the service had won awards for their efforts in a Community Initiative.

People were happy with processes for managing their medicines. We reviewed medicines administration and documentation and found this to be safe.

The home was clean, tidy and maintain

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

Thornton Lodge Residential Care Home supports people with mental health needs. It is registered to provide care and accommodation for up to 36 people. The home is situated close to shops, buses, the beach and local facilities in Morecambe.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

This was an unannounced inspection undertaken on the 12th August 2014.

Every staff member we spoke with was positive about their work and how care and support was provided to the people who lived at the home. They all said they were supported by the management team. One said, “The manager and senior staff are fantastic very supportive.”

Each person who lived at the home had an allocated member of staff known a keyworker. This enabled people and their families to have a named person who worked with them closely to ensure care and support was delivered as planned. We saw if people's needs changed their care plans would be reassessed to ensure they received the support they needed. We found people were involved in decisions about their care and were supported to make choices as part of their daily life. This was confirmed by talking with people. One person who lived at the home said, “I go out and about if I want it is my choice.” The staff team worked with the person and their relatives to develop relationships. This ensured staff were aware of what was important to people they supported and how they could best enable people to live an independent life as possible.

We found individual risks had been assessed and identified as part of the care planning process. Control measures had been put in place to manage any risks in a safe and consistent manner. This meant people were supported to take appropriate risks especially when out in the community and staff were aware of any potential risks to people’s health and well-being.  This ensured people were protected and staff promoted their independence and freedom.

Staff received on-going training and development in the areas of care and support people required. Mandatory training was provided for staff that included, moving and handling, first aid and safeguarding. Staff told us they were supported to access training outside the home and the registered manager supported staff to develop their skills and improve their knowledge of caring for people. This meant staff were provided with the skills to be able to provide the support people with mental health needs required.

We observed people’s privacy and dignity was respected. Interaction between staff and people who lived at the home was good. One person said, “The staff do remarkably well with us all. Plenty to do. I go down town myself, the staff encourage me to be as independent as possible.”

There were sufficient numbers of staff available to assist people with personal care, activities and food and drinks. Staff helped people in a dignified way so people could enjoy their food. All comments from people were positive in terms of quality and quantity of the meals. Comments from people who lived at the home included, “The food is good, plenty of it.”

The service had policies in place in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA and DoLS provide legal safeguards for people who may be unable to make decisions about their care. We spoke with the registered manager  and some staff members to check their understanding of MCA and DoLS. They had a good awareness of the code of practice and confirmed they had received training.  The registered manager understood when an application should be made, and how to submit one.

People who lived at the home told us they were cared for and supported by staff that were knowledgeable about their needs and wishes. One person said. “I feel comfortable with the staff they all seem qualified and experienced in what they do.”

Thorough recruitment and selection procedures were in place and appropriate checks had been undertaken before staff commenced their employment. This was confirmed by talking with staff and looking at recruitment records. One staff member said “Cannot fault the way they checked everything before I started to work here.”

The management team assessed, audited and monitored the quality of care consistently. The service encouraged feedback from people who lived at the home, stakeholders and families, which they used to make improvements to the service. One relative we spoke with said, “The good thing about the home they are always trying to improve things for the good of the residents.” Also a person who lived at the home said, “They ask our opinions, what we think and what would improve the home.”

During this inspection visit we spoke with five people who lived in the home and with two staff.

People told us they were happy with the care and support they received. Comments included, “It’s a lovely place; I am very well looked after” and “I like living here; I get on with everyone”.

People told us they were offered choices and had been involved in agreeing and reviewing their care plan. We observed staff seeking people’s opinions and offering advice and support as needed. Comments included, “I can do as I like” and “I can mostly do what I want”.

People told us about the various activities available both in the home and in the local community. They told us they were involved in discussions and decisions about the activities they would prefer.

People told us they enjoyed the food. Comments included, "The food is very good with different choices" and "The food is very good; very tasty".

Records confirmed a safe and effective recruitment process had been followed which should help to make sure that only suitable staff were employed.

People were happy with the staff team. Comments included, "Staff are very good with me", "I get on well with the staff; we can have a laugh" and "The staff are lovely; they treat me well".

People told us they had no complaints about the service. Comments included, “I can raise any concerns and they are sorted quickly” and “I can talk to staff or to the manager if things are not going well for me".

People said they were happy living at Thornton Lodge. People told us that staff assisted them to be as independent as possible and respected their privacy. One person told us he realised that he needed sheltered living and felt staff supported him well to be reasonably independent. Another person said, “I have lived here for a long time and enjoy being here. The staff are good”.

We observed people being treated with respect and dignity. Staff supported people in a relaxed unhurried way, encouraging them to carry out tasks and activities. We saw that routines in the home were flexible and people were encouraged to make their own decisions about their daily routine.

People living in the home said they felt that people were safe at Thornton Lodge. They said they could talk to staff if they were worried about something and staff would help. One person told us, “The staff are very caring and don’t patronise me.”

We observed care and staffing numbers during the inspection and also looked at staff rotas. There were satisfactory numbers of staff to support people in the way they needed.

Senior staff regularly monitored the care in the home and spoke with people to check they were satisfied with the care they received.