The Thatched House

Updated 18 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

Two inspectors undertook this inspection.

Service and service type

The Thatched House 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. The Thatched House is a care home without nursing care. The Care Quality Commission (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 CQC 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 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 asked the local authority for information they had about the service. 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 four people who used the service and six relatives about their experience of the care provided. We spoke with five members of staff including the registered manager, the nominated individual and both day and night-time care workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with a visiting health care professional. We spent time talking to people and observing how staff interacted with them.

We reviewed a range of records. This included four people's care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at records from meetings, two care plans and staff rotas.

Updated 18 October 2022

About the service

The Thatched House provides accommodation with personal care for people over age of 65, some of whom were living with dementia. The service is registered to accommodate up to 20 people in one adapted building. There were 18 people living in the home at the time of this inspection.

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

Some areas of the home, including people’s bedrooms, were not well maintained and hygienic, and systems for managing and preventing infections were not robust. This increased risks to people, had an impact on their comfort and did not support their dignity. Relatives were consistent in their views that the environment, including people’s bedrooms and bathrooms, needed attention.

The provider’s recruitment practice did not promote safety because suitable checks had not always been completed and documented. Systems for supporting and training staff were not consistent. Systems for monitoring the quality of the service and supporting improvements were not effective.

People told us they were happy at the home and relatives spoke highly of the care provided to people. Their comments included, “The care is very good” and, “Staff are all nice and kind, people are well looked after.”

There were enough staff to provide safe care and people were protected from risks of abuse. Staff were trained to administer medicines to people and staff were knowledgeable about people’s individual needs.

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 supported people to access the health care services they needed and worked effectively with other agencies. People were supported to have enough to eat and drink and spoke highly of the food and the choices on offer. One person said, “Mealtimes are very enjoyable.”

There was an open and inclusive culture where people and staff were encouraged to contribute their views and ideas. Staff were proud of their work at the home, one staff member told us, “It is a lovely place to work, people are very well cared for here.”

People and their relatives spoke highly of the provider. One relative told us, “Communication is very good, they are on the ball with keeping us informed.”

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 September 2021)

Why we inspected

We received concerns in relation to infection prevention and control, hygiene and maintenance standards at the home. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

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.

Following the inspection, the provider sent us information about the improvements that they had already put in place. These will be considered at a future inspection.

For those key questions 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 good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Thatched House on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to the management of risks, maintenance of the premises, recruitment procedures, record keeping and management oversight and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect..