CQC report explained · a care home with nursing
What the CQC found at Thistle Hill Hall
Rated Outstanding: inspectors found the home performing exceptionally well.
- Safe?
- Outstanding
- People felt safe and staff were trained to recognise and report abuse. Inspectors found strong risk management, safe medicines systems, enough staff and detailed emergency plans.
- Effective?
- Outstanding
- People had detailed assessments and care designed around their health, choices and recovery goals. Staff had a wide range of skills and worked closely with specialist mental health professionals.
- Caring?
- Outstanding
- People were treated with kindness, dignity and respect, and were involved in decisions about their care. Staff supported people's individuality, privacy, communication and independence.
- Responsive?
- Outstanding
- Care was highly personalised and adapted to changing needs. People were supported with activities, education, employment, relationships, communication and community involvement.
- Well-led?
- Outstanding
- Inspectors found exceptional leadership, an open culture and effective checks on quality and safety. The provider showed a strong commitment to learning, innovation and continuous improvement.
What inspectors found, June 2020
Rated Outstanding; inspectors found exceptional safety, care, responsiveness and leadership, with all five ratings maintained.
This was an unannounced planned inspection of the home. One inspector visited on 30 December 2019 and 2 January 2020. They spoke with people living there, relatives, staff and outside health and social care professionals. They also reviewed care records, medicines records, staff files and quality checks.
The home provided personal and nursing care for 21 people living with mental health conditions. Inspectors found that people felt safe and were supported to take positive risks, manage medicines, build independence and work towards recovery. Staff were described as skilled, kind and responsive to individual needs.
The home was rated Outstanding in all five areas: Safe, Effective, Caring, Responsive and Well-led. This means inspectors found care that was exceptional and distinctive, with people's choices, wellbeing, recovery and independence at the centre.
The previous inspection, published in May 2017, also rated the home Outstanding. Since then, inspectors found further developments, including personal safety training, a new electronic care notes system, more community activities and work to reduce the use of restrictive practices and some medicines.
Safety and positive risk-taking
People were involved in understanding risks and were supported to become more independent without losing sight of their safety.
“People were supported to take risks appropriately, and this was balanced against people's wishes to be as independent as possible.” from the report
Kind, individual care
Staff knew people well and adapted support to their wishes, identity, communication style and recovery goals.
“People were respected and valued as individuals.” from the report
Support for independence
The home helped people build practical skills, take part in education or work, use the community and move towards more independent living.
“Promoting independence was a key objective for people and staff.” from the report
Strong specialist support
People could access a range of mental health professionals, and staff worked closely with outside health and social care services.
“People had access to an expert team of specialist mental health professionals.” from the report
Listening and improvement
People could give feedback in several ways. The provider used complaints and suggestions to make changes, such as adding internet access and a savings club.
“The provider displayed "You said – We did" information at the service to show people what action was taken when they gave feedback.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you assess and support my relative's mental and physical health needs before offering a place?
- 02How would my relative be involved in taking positive risks and working towards their own recovery and independence goals?
- 03Which specialist mental health professionals would be involved in my relative's care, and how often would they review it?
- 04How would you support my relative to manage medicines safely and, if appropriate, gradually take more control of them?
- 05How would you adapt communication, activities and care if my relative's needs, identity or preferences changed?
This was an unannounced comprehensive inspection covering all five key questions, including the premises and the care provided. This explanation was written from the published report of 24 June 2020 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, April 2017
Rated Outstanding in all five areas; inspectors found exceptionally safe, caring and personalised support focused on recovery and independence.
This was an unannounced inspection on 9 and 10 February 2017. Inspectors spoke with people living at the home, relatives, staff and a health professional. They reviewed care records, medicines records, recruitment and training records, incident information and management audits.
The home supports up to 23 adults with mental health support needs. Inspectors found strong systems for safeguarding, risk management and medicines. Staff helped people make decisions, manage risks and medicines, take part in meaningful activities, and build skills for greater independence.
All five areas were rated Outstanding: Safe, Effective, Caring, Responsive and Well-led. This means the inspection found care that was consistently exceptionally good, with evidence of a strong positive impact on people's lives.
Safety with independence
Staff managed risks carefully without placing unnecessary restrictions on people. The home used creative solutions and learned from accidents and near misses.
“Risks had been thoroughly assessed and actions had been taken to reduce them whilst minimising the restrictions placed on people” from the report
Skilled health support
People had access to staff with different nursing skills and to specialist mental health professionals. Inspectors found that this support helped people's recovery and wellbeing.
“People received ongoing healthcare support from a range of internal and external healthcare professionals and staff used innovative way of promoting people's mental and physical wellbeing.” from the report
Kind and respectful staff
Staff knew people well, listened to them and gave reassurance when they were distressed. Privacy, dignity and personal identity were treated as important.
“We observed kind and respectful interactions where people were given time to express themselves fully.” from the report
Personalised recovery
Support was built around each person's goals, interests and changing needs. People were helped to develop confidence, education, employment and daily living skills.
“People received a personalised service which was responsive to their individual needs and there was an emphasis on person's identity and their recovery and rehabilitation” from the report
Meaningful activities
The home offered activities seven days a week, both at the home and in the community. These were linked to people's goals and helped develop practical and social skills.
“Activities were purposeful and outcome based.” from the report
Open leadership
Inspectors found a clear vision, strong involvement of people and staff, and regular checks on quality and safety. The home used feedback and incidents to improve its work.
“Robust and frequent quality assurance processes ensured the safety and quality of the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you adapt the rehabilitation programme and daily activities to my relative's interests, goals and changing mental health?
- 02How would you support my relative to manage their medicines safely and increase their independence over time?
- 03How do you assess and review risks while avoiding unnecessary restrictions on a person's freedom?
- 04What specialist mental and physical healthcare support would be available for my relative?
- 05How would you involve my relative and our family in care planning, feedback and complaints?
This was an unannounced comprehensive inspection covering all five questions: Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 29 April 2017 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Thistle Hill Hall
3 rated inspections over 5 years: the service has improved, from Requires improvement to Outstanding.
- June 2020Outstandingcurrent ratingstayed OutstandingSafe: OutstandingEffective: OutstandingCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- April 2017Outstandingup from Requires improvementSafe: OutstandingEffective: OutstandingCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- March 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2010
Registered with the Care Quality Commission on 7 December 2010.
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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