Background to this inspection
Updated
5 January 2024
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.
Inspection team
The inspection team consisted of 2 inspectors 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.
Service and service type
Thistle Lodge 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. Thistle Lodge 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
The inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service. We sought feedback from the local authority and integrated care board who commissioned care with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We visited the service on 15 November 2023. We spoke with 9 staff members including the registered manager, operations manager, an assistant psychologist, registered nurse, support workers and cook. Staff created inspector profiles in a format they could understand to provide all people living at the service the opportunity to speak with us. Only 1 person wanted to speak with us. We spoke with 5 relatives of their experience of the care provided. We spoke with 2 specialist care consultants who worked with the service. We reviewed a range of records. This included 3 people's care records and their medicine records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including incident management, improvement plans, and maintenance records were reviewed.
Updated
5 January 2024
About the service
Thistle Lodge is a specialist residential care home providing personal and nursing care to up to 7 people. The service provides support to people with a learning disability, autistic people, and people with mental health support needs. People using the service had their own self-contained apartment, with specially adapted facilities that met their individual needs, within one building. At the time of our inspection there were 6 people using the service.
People’s experience of the service and what we found:
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support
Whilst people had many restrictions in place to keep them safe from harm these were lawful and in line with their assessed need. 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. Staff delivered care and support in line with people’s needs and strengths. People received their medicines safely. Lessons had been learnt following incidents which decreased the risk of recurrence.
Right Care
Staff understood their responsibility to protect people from poor care, neglect and abuse. Staff completed safeguarding training and reported incidents to the registered manager. Individual risks were accurately assessed, and risk reduction measures were in place. People received kind and caring support tailored to their individual needs.
Right Culture
Staff supported people to set realistic goals in order to live a more fulfilled life. People were supported by staff who completed specialist training to support people with complex needs. Effective quality monitoring systems were in place to ensure the quality-of-care people received improved. The culture was open and honest. The registered manager displayed a passionate attitude who worked with and acted on feedback from partners.
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 requires improvement (published 15 March 2023).
Why we inspected
The inspection was prompted due to concerns received about the management and reporting of incidents. A decision was made for us to inspect and examine those risks. We found the provider had taken appropriate action to address the concerns.
We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good.
You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Thistle Lodge Robins Wood Road on our website at www.cqc.org.uk.
Follow Up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.