Archived: Thistlegate House

The overall rating for this service remains as ‘Inadequate’. We have kept this service under review while we took action to cancel the providers registration as a result of breaches in regulation resulting in people receiving inadequate care.

We took action to cancel the provider’s registration following our inspection in April 2015 as the provider had failed to make the significant improvements necessary. These legal proceedings have now concluded and we are able to report on the outcome of the actions we have taken. The provider appealed against our decision to cancel their registration. This appeal was heard by the Care Standards Tribunal, this appeal was dismissed by the tribunal and their registration was cancelled on 11 May 2016.

This unannounced inspection took place on the 27 and 29 October 2015. Thistlegate House provides accommodation and personal care for up to 18 older people. There were 5 people with complex care needs associated with dementia and restricted mobility, living in the service when we visited.

There was a registered manager in post. 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. The registered manager owned the home in partnership with one other person. This person is referred to in the report as co-owner. They both live in the home and were both present providing care alongside the staff.

We had inspected the service in January 2014, January 2015 and April 2015 and had concerns about the quality of care. There were breaches of regulations and we told the provider to take action to ensure they met the regulations.

During our inspection we found a number of the concerns identified at these previous inspections remained. People’s care was not assessed appropriately and this meant that care did not reduce the risks that people faced and might not meet people’s needs.

Staff did not know where to report abuse to and the information available to them was out of date. This meant there might be delays in reporting abuse which would put people at an increased risk of harm.

Staff did not have a shared understanding of the evacuation procedure and fire exits were blocked.

Consent to care was not sought in line with legislation and this put people at risk of not receiving care that was in their best interests. This also put staff at risk because they were providing care that people had not agreed to without the protection of the law.

There were enough staff but their training was not all up to date and this put people at risk of receiving inappropriate or unsafe care.

Care staff were all kind and compassionate but people were sometimes treated in ways that were not respectful. Records sometimes contained language that was judgemental and did not respect the person it referred to.

The registered manager did not operate a system that was effective in ensuring people received good quality care. They had not responded appropriately to concerns identified in our previous inspections or to requirements made by environmental health professionals relating to the safety of the kitchen. The registered manager shouted at inspectors on a number of occasions during our inspection.

Staff were working to increase the meaningful activities available to people. The staff had tried a variety of activities with people during a weekly scheduled activity slot. This remained insufficient to meet people’s well-being needs.

Appropriate applications for DoLS had been made and granted for three people and a further application had been submitted.

People had access to health care professionals and advice had been sought about some aspects of people’s health.