We carried out a review of the data available to us about Thistle Hill Hall on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Thistle Hill Hall, you can give feedback on this service.
Thistle Hill Hall is a residential care home providing personal and nursing care to 21 people at the time of the inspection. The service can support up to 23 people who are living with mental health conditions. People who use the service have access to a rehabilitation programme to support their recovery and promote their independence. The service is based around each person's individual needs and is therefore not time limited. The home provides five self-contained flats and 18 single bedrooms, over two floors. There are three communal lounges, a dining room, activities room, gym and a large garden.
People’s experience of using this service and what we found
Thistle Hill Hall continued to maintain an outstanding quality of care for the people living there. The provider and staff team had a proactive approach to continuous development, always looking for new ways to support people to recover and maintain their independence. For example, since our last inspection, the provider had developed skills training for people to include personal safety awareness, bespoke first aid training, and was trialling virtual-reality (VR) enabled therapy designed to offer graded exposure to situations in a safe environment.
People felt safe living at the service, and their safety and well-being was a priority for the staff team. People were empowered to play a full part in recognising risks to their mental and physical health and encouraged to take positive risks in their daily lives. Health and social care professionals knew the staff team had a strong culture of managing risks in people’s care and balancing this against the need for people to develop more independent lives.
People were supported with managing their medicines safely, and staff had a proactive approach to reducing the use of medicine to manage mental health symptoms that caused people distress. The staff team supported people to find other positive ways of managing symptoms of their mental health conditions, whilst being mindful of the part medicines also played in keeping people well. For example, there was an emphasis on maintaining physical well-being through a variety of activities. People also had access to a range of therapy activities such as art therapy and yoga, to give them different ways of managing stress and anxiety.
People were supported by a diverse staff team with a wide mix of skills, including specialist nursing staff and technical instructors. Staff described a thorough induction process, and confirmed they felt very supported and well trained by the registered manager and provider. The staff team was committed to working collaboratively with external health and social care professionals to achieve the best outcomes for people’s recovery. Feedback from external health and social care professionals continually emphasised the excellent teamwork all staff at Thistle Hill Hall demonstrated when working together with people to improve their mental health care.
People told us staff were creative and enthusiastic when it came to supporting them to live healthier lives and access external healthcare services. The provider took innovative approaches to ensure people were supported to maintain their health. People had access to an expert team of specialist mental health professionals, who worked with each person to provide a tailored approach to recovery.
The staff team remained committed to maximising people’s ability to have control and choice in their lives. People’s rights were protected because staff understood and acted in accordance with the relevant legislation. 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.
People were respected and valued as individuals. People, relatives and external health professionals were consistently positive about the exceptional care provided by the staff team. People’s wellbeing, recovery and empowerment was at the centre of the staff team’s ethos. Care and support was designed by people, relatives, the staff team and external professionals collaboratively, and was based on combining people’s needs and wishes for their recovery with nationally accepted best practice in mental health care. We saw how equality and respecting people’s diversity and individuality was embedded in the staff team’s approach to enabling people to live the lives they wanted.
The service was exceptionally person-centred and responsive to people's individual needs. People’s individual and diverse needs were recognised throughout the assessment and care planning process. The provider was open-minded and innovative when it came to providing care to people. This included the use of technology to support people become more independent and confident.
The staff team were very focussed on delivering person-centred care and were responsive to people’s changing needs. People were strongly encouraged to continue with their favourite activities and hobbies and supported to develop new ones if this was what they wanted. People and relatives spoke positively about the range of structured activities that were available at Thistle Hill Hall, describing how these enabled them to move toward their goal of recovery and independent living.
People were listened to and there were systems in place to obtain people's views about their care. People were encouraged to provide regular feedback on the service and felt they could raise concerns. Complaints were taken seriously, investigated and responded to sensitively.
The service was exceptionally well-led. Everyone we spoke with was consistently positive about the service and the way in which people were supported to live the lives they wanted. The staff and management team at Thistle Hill Hall were dedicated, creative and determined to ensure people were at the heart of service. Staff were highly motivated and clearly took pride in the high-quality compassionate care they offered.
The registered manager and provider demonstrated consistently excellent leadership qualities. The provider worked with the management team and staff to deliver a clear vision of the service, which was focussed on recovery and empowering people to live independent lives. The service maintained excellent links with health and social care professionals and other organisations in the local community. There was a strong emphasis on continuous improvement and development of the service.
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 Outstanding (published 2 May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Thistle Hill Hall provides high quality accommodation, personal care and nursing to adults with support needs relating to their mental health. People who use the service have access to a rehabilitation programme to support their recovery and promote their independence. The service is based around each person’s individual needs and is therefore not time limited. The home provides five self-contained flats and 18 single bedrooms, over two floors. There are three communal lounges, a dining room, activities room, gym and a large garden.
The service had a registered manager in place at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
We found that Thistle Hill Hall was a truly innovative and inspiring home which put people at the heart of service.
People who used the service felt safe in the service and the community. People were, as far as possible, empowered and enabled to take responsibility for their own safety. There were systems and processes in place to minimise the risk of abuse and staff were very clear about their role in safeguarding people from harm. There was a culture of transparency and people were encouraged to whistle blow on poor practice.
Risk associated with people’s care and support were managed safely whilst promoting independence. The management team explored and invested in innovative solutions to ensure people’s safety. There were effective, organised systems in place for the safe handling of medicines. The staff team were committed to enabling people gain independence in managing their own medicines.
The team at Thistle Hill Hall were passionate about maximising people’s capacity to make decisions and choices in their lives. People's rights were protected because staff acted in accordance with the Mental Capacity Act 2005. The principles of the Deprivation of Liberty Safeguards were understood and applied correctly and the team were committed to ensuring that people were supported in the least restrictive way possible.
People received effective healthcare support from a range of internal and external healthcare professionals and staff used innovative ways of promoting people’s mental and physical wellbeing.
People were supported to eat and drink enough, they were encouraged to make choices about food and drink and provide feedback. A creative approach was taken to building people’s independence and skill with cooking.
People were supported by a team of staff who were highly skilled in meeting people's needs and who received on-going training and development opportunities to enable them to deliver the most effective service.
The service had a person centred culture focussed on the promotion of people's rights to make choices and live a fulfilled life as independently as possible and this resulted in people being valued and treated as individuals. People received a personalised service which was responsive to their individual needs and there was an emphasis on people’s identity and diverse needs and their recovery and rehabilitation from the moment they moved into the service.
People were supported by exceptionally caring staff that knew them well and understood how to support them to maximise their potential and attain their goals. People's progress was monitored and celebrated. Staff were constantly looking for opportunities that would help people grow, gain confidence and live a fulfilled life. People were supported and encouraged with their goals of moving back into the community. People's rights to privacy and dignity were valued and respected.
The team at Thistle Hill Hall placed a strong emphasis on enhancing people's lives and facilitating their recovery through the provision of meaningful, outcome focused activities and opportunities. The service was committed to building strong links with the community.
People were listened to and there were systems in place to obtain people's views about their care. People were encouraged to provide feedback on the service and felt they could raise concerns. Complaints were taken seriously, investigated and responded to compassionately.
The registered manager was inspiring and dedicated to providing care which met the highest of standards. They strived for excellence through consultation, they were passionate and dedicated to providing an outstanding service to people.
A clear vision for the promotion of mental and physical well-being was embedded throughout the home and there was a strong commitment to deliver a high standard of personalised care. There was a culture of continuous learning, development and improvement at Thistle Hill Hall and creative solutions were developed in response to adverse events.
Robust and frequent quality assurance processes ensured the safety and quality of the service. Practice was evidence based and regular evaluations took place to ensure that the service had a positive impact on the lives of the people living at the home.
This inspection took place on 28 and 29 October 2014. Thistle Hill Hall provides a mental health rehabilitation service for up to 18 adults aged 18-65 years old. On the day of our inspection 18 people were using the service.
The service had a registered manager in place at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.
We last inspected Thistle Hill Hall in November 2013. At that inspection we found the service was meeting all the essential standards that we assessed.
People were encouraged to talk about how they could keep themselves safe. Staff took appropriate action to minimise the risks to people’s safety. The provider had not assessed the number of staff that were needed on duty at any given time to ensure people were safe from harm anywhere in the building. We have made a recommendation about the staffing levels.
Medicines were managed safely and people received their medication in an individual manner that best suited their needs. People were supported to manage their own medicines as this would help with their rehabilitation programme.
Staff received training and support to ensure they had the knowledge and skills to provide safe and appropriate care and support.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The DoLS is part of the MCA, which is in place to protect people who lack capacity to make certain decisions because of illness or disability. DOLS protects the rights of people by ensuring that if there are restrictions on their freedom these are assessed by professionals who are trained to decide if the restriction is needed. We found this legislation was being used correctly to protect people who were not able to make their own decisions about the care they received. We also found staff were aware of the principles within the MCA and had not deprived people of liberty without applying for the required authorisation.
People were involved in planning the weekly menu and mealtimes were made into social occasions. People had sufficient food and drink to maintain their health and were informed of the importance of a healthy diet. People were supported with their healthcare needs and these were reviewed regularly.
We observed people being treated with dignity and respect and enjoy interacting with staff. Staff took the time to understand what support people required and listened to their views.
People were supported to develop skills that would enable them to live independently. People knew how to raise any complaint of concerns they had and these were considered and responded to.
People who used the service and staff were encouraged to express their views on how the service was run. There were systems in place to monitor the quality of the service but when shortfalls were identified these were not always acted upon.