CQC report explained · a nursing home
What the CQC found at Thistle Hill Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and managed, medicines were handled safely, and staff understood safeguarding procedures. Infection control was generally effective, but the policy needed review regarding unpleasant odours.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its rating was carried forward from the previous inspection.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its rating was carried forward from the previous inspection.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its rating was carried forward from the previous inspection.
- Well-led?
- Good
- Inspectors found effective checks, audits and oversight. Staff understood their roles, care plans were reviewed, and people said managers listened to concerns and suggestions.
What inspectors found, July 2023
Thistle Hill Care Centre is rated Good; inspectors found safe, well-managed care, with a recommendation about unpleasant odours.
This was an unannounced focused inspection on 13 and 20 June 2023. One inspector and an Expert by Experience spoke with residents, visitors, relatives and staff. They also observed medicines practice and checked care plans, staff files, records and policies.
The home was rated Good for Safe and Well-led. Inspectors found that risks, medicines, safeguarding, staffing and infection control were generally managed safely. Care plans and emergency evacuation plans were up to date, and incidents were reviewed so lessons could be shared.
The inspection found that improvements had been made since the previous rating of Requires Improvement in 2021. The home was no longer in breach of regulations. Inspectors recommended reviewing the policy for dealing with unpleasant odours, although they found no evidence that people were harmed by this.
Safe medicines practice
Medicines were received, stored, given and disposed of safely. Staff had recent training and their practice was observed.
“Medicines were received, stored, administered, and disposed of safely.” from the report
Risk management
Care plans included current risk assessments and steps to reduce known risks. Staff discussed changes in people's needs and updated plans.
“Risks to people's safety and welfare were assessed and well managed.” from the report
Learning from incidents
The home reviewed incidents and concerns, identified trends and shared learning with staff to help prevent similar events.
“Good governance procedures ensured incidents and concerns were reviewed and evaluated.” from the report
Listening to people
People and relatives said they could raise concerns and that managers responded to suggestions. Meetings were used to gather feedback.
“People and staff told us the home was well run, the registered manager was approachable, and responsive to any suggestions or concerns.” from the report
Unpleasant odours
minorInspectors recommended that the infection prevention and control policy should be reviewed so that unpleasant odours are dealt with within reasonable timescales. They found no evidence that people were at risk of harm from this issue.
“We recommend the provider takes action to review their policy to ensure practice effectively removes and mitigates lingering offensive or unpleasant odours in reasonable timescales.” from the report
- 01What changes have you made to the policy and practice for dealing with unpleasant odours?
- 02How quickly are reports of unpleasant odours investigated and resolved?
- 03How do you check that care plans and personal emergency evacuation plans remain up to date?
- 04How do you use incident and falls information to reduce risks for residents?
- 05What were the current ratings and findings for Caring, Effective and Responsive at the previous inspection?
This was a focused inspection of Safe and Well-led; Caring, Effective and Responsive were not inspected and their ratings carried over from the previous inspection. This explanation was written from the published report of 6 July 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, February 2022
Thistle Hill Care Centre was inspected but not rated; inspectors found good infection control in several areas, but some policies and risk assessments were not fully effective.
This was an announced, targeted inspection on 27 January 2022. Inspectors looked at infection prevention and control, visiting arrangements, and whether COVID-19 staffing pressures affected care.
The home was following government guidance during a COVID-19 outbreak. Inspectors were assured about visitors, admissions, protective equipment, testing, hygiene, and managing outbreaks. Visiting arrangements had also been brought into line with government guidance.
Inspectors found some weaknesses. Guidance for staff about supporting people with COVID-19 was not available as the policy said it should be. Some risk assessments were missing or not person-centred, and records did not always explain visiting arrangements or social distancing choices.
The service was inspected but not rated. This means the inspection did not give an overall quality rating or full ratings for the five questions.
Infection control measures
Inspectors were assured that the home was taking several practical steps to reduce infection risks, including testing, PPE, hygiene and outbreak management.
“We were assured that the provider was using PPE effectively and safely.” from the report
Visiting options
The home offered different ways for families to visit, including purpose-built outdoor visiting pods and end of life visits.
“The home had two purpose built, accessible, visiting pods outside for people to use when it was not possible to come into the home.” from the report
Activities and contact
The home provided virtual events and activities when people could not leave, and offered alternatives when indoor visits were not possible.
“The service offered a variety of virtual events and activities for people when they were unable to leave the home.” from the report
Updated visiting policy
Although the visiting policy had previously not followed government guidance, it had been reviewed and was in line with that guidance at the inspection.
“However, at the time of the inspection this had been reviewed and was in line with government guidance.” from the report
COVID-19 staff guidance
needs fixingThe infection control policy was up to date, but it had not been put into practice fully. Staff guidance on supporting people with COVID-19 was not available as the policy required.
“Guidance for staff on how to best support people with COVID-19 was not available as per the policy.” from the report
Risk assessments
needs fixingSome risk assessments were missing, and those that were available were not always tailored to the person. This included arrangements for people sitting close together during an outbreak.
“Risk assessments were not always available and the risk assessments that were in place were not person-centred.” from the report
Social distancing records
needs fixingPeople were observed sitting close together during a group activity while the home was in an outbreak. It was not clear whether this was their choice or had been risk assessed.
“It was not clear in documentation or risk assessments whether this was the individual's choice and whether this had been risk assessed.” from the report
Visiting records
minorCare plans and risk assessments did not always record people's circumstances and arrangements for visiting.
“However, care plans and risk assessments didn't always reflect people's circumstances and arrangements around visiting.” from the report
- 01How do you make sure staff have current guidance on supporting people with COVID-19?
- 02How do you make sure every person's infection control risk assessment is available and tailored to them?
- 03How do you record people's choices and risk assessments for communal activities during an outbreak?
- 04How are each person's visiting arrangements and circumstances recorded in their care plan?
- 05What visiting options are available now if indoor visits are restricted?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19 staffing pressures; it did not provide a full rating of the service. This explanation was written from the published report of 18 February 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Thistle Hill Care Centre
7 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- July 2023Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2022Inspected but not ratedSafe: Inspected but not rated
- July 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- July 2018Goodup from Requires improvementSafe: GoodWell-led: Good
- June 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2016Requires improvementdown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2015Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 February 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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