Thistle Lodge Robins Wood Road

Thistle Lodge is a specialist residential care home providing personal and nursing care to up to 7 people. The service provides support to people with a learning disability, autistic people, and people with mental health support needs. People using the service had their own self-contained apartment, with specially adapted facilities that met their individual needs, within one building. At the time of our inspection there were 6 people using the service.

People’s experience of the service and what we found:

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support

Whilst people had many restrictions in place to keep them safe from harm these were lawful and in line with their assessed need. 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 delivered care and support in line with people’s needs and strengths. People received their medicines safely. Lessons had been learnt following incidents which decreased the risk of recurrence.

Right Care

Staff understood their responsibility to protect people from poor care, neglect and abuse. Staff completed safeguarding training and reported incidents to the registered manager. Individual risks were accurately assessed, and risk reduction measures were in place. People received kind and caring support tailored to their individual needs.

Right Culture

Staff supported people to set realistic goals in order to live a more fulfilled life. People were supported by staff who completed specialist training to support people with complex needs. Effective quality monitoring systems were in place to ensure the quality-of-care people received improved. The culture was open and honest. The registered manager displayed a passionate attitude who worked with and acted on feedback from partners.

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 requires improvement (published 15 March 2023).

Why we inspected

The inspection was prompted due to concerns received about the management and reporting of incidents. A decision was made for us to inspect and examine those risks. We found the provider had taken appropriate action to address the concerns.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key question 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 requires improvement to good.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Thistle Lodge Robins Wood Road on our website at www.cqc.org.uk.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

Engagement with external professionals was not always timely and the managers review of incidents did not always identify issues that required further follow up to meet people's holistic care needs.

Staff provided support to people which ensured they maintained good health. Medication was managed safely and people were supported to access support from health professionals.

People were supported by staff who had been safely recruited and were trained to be able to effectively support people.

Incidents requiring the use of physical intervention were managed safely. People, and their staff team, had access to appropriate equipment to support them effectively.

Right Care:

Systems were in place to provide management oversight. However, managers and staff were not always clear about their role in relation to the effective use of these systems, so issues that could impact people's care were not always identified.

Staff were respectful and supported people in a way that demonstrated they valued people's differences and equality needs. This was reflected in person-centred care plans and risk assessments.

People were supported to communicate using accessible information, and their diverse needs and choices were respected because they were receiving regular support from consistent staff.

People were supported by friendly and caring staff so people received compassionate care, staff respected their choices and treated them with dignity.

Right Culture:

People were not always empowered to live inclusive lives that enabled them to achieve positive outcomes.

Staff were appropriately trained for their role and received support from the management team so people received support from staff that understood how best to support them.

The provider was open, honest and responsive in relation to feedback during the inspection and committed to make improvements based on this to improve people's quality of life.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This service was registered with us on 18 February 2022 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about people’s living conditions, support and use of restrictive practice. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. The provider took immediate action to address concerns implementing further medicines stock count checks, a restructure of how the service is managed and improved oversight and auditing systems and processes.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.