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Thistle Hill Care Centre Good

Inspection Summary

Overall summary & rating


Updated 17 July 2018

Thistle Hill Care Centre is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Thistle Hill Care Centre is situated in Knaresborough and provides nursing care for up to 85 younger adults or older people, who may be living with dementia or a physical disability. The home is divided into three units. The Deighton unit provides care for up to 41 people who may be living with dementia. The Ripley unit provides care for up to 24 older people who require general nursing care and the Farnham unit provides care for up to 20 younger adults with disabilities.

Inspection site visits took place on 8 and 10 May 2018 and were unannounced. At the time of this inspection there were 62 people living at the service.

At the last inspection in March 2017 we identified a breach of regulation in relation to good governance. This was because the registered provider had failed to ensure effective systems or processes to assess, monitor and improve the quality and safety of the services provided and mitigate risks, had not been operated.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions safe, effective and well-led to at least good. At this inspection we found the provider had implemented their action plan and were no longer in breach of regulation.

There was a new manager in post who had registered with CQC in November 2017. 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.

Effective quality assurance processes were now in place and were used to identify shortfalls within the service. Timely action had been taken when shortfalls or concerns had been found. The registered manager was supported by a senior management team who visited the service on a regular basis to monitor improvements that were being made.

The use of agency staff was still high but the registered manager ensured only agency staff that were familiar with the service were used. Agency staff profiles were available and contained the required information to evidence they had the skills, knowledge and experience to support people at the service. Safe recruitment processes had been followed and appropriate pre-employment checks were completed.

There was enough staff on duty that had been deployed effectively. Calls bells were answered in a timely manner and staff were visible throughout the service.

Medicines had been managed, administered and stored appropriately. Staff competencies with regards to medicines had been assessed which ensured they had the relevant skills and training to administer medicines safely.

Risk assessments were in place where required and contained sufficient information. Staff were aware of their responsibilities in relation to safeguarding and referrals to the local authority had been made when required.

People were supported to maintain a balanced diet and there was a variety of meals on offer as well as refreshments and snacks throughout the day. Appropriate monitoring tools were completed to highlight any concerns in relation to weight loss or gain. Where concerns were identified, appropriate professionals had been contacted.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

Staff received effective support from the management team. Regular supervisions and observations of practice took place as well as annual appraisals. These gave staff the opportunity to develop within their role. Regular training had been completed in areas the provider considered mandatory as well as specialist training where required.

Staff treated people with dignity and respect. They were familiar with people’s needs, likes and dislikes and how best to support them. Positive relationships had been developed between people and staff.

Care plans contained person-centred information and focused on how people wished to be supported. A range of activities were available and people said activities were much improved. The registered manager had begun to build relationships within the local community.

Resident and relative meetings had been reintroduced and feedback had been sought via satisfaction surveys. People spoke positively about the management team and the improvements they had made to the service.

Inspection areas



Updated 17 July 2018

The service was safe.

People were protected from the risk of avoidable harm or abuse. The provider had effective systems in place to manage any safeguarding concerns.

Risk assessments had been developed and were in place when required.

Pre-employment checks on employees were completed that helped to minimise the risk of unsuitable people working with vulnerable adults.

Medicines had been stored and administered safely.



Updated 17 July 2018

The service was effective.

Staff had received sufficient training, supervisions and observation of their practice to ensure they had the skills and knowledge to carry out their roles and responsibilities.

People were supported to maintain a balanced diet and spoke positively about the meals provided.

People had access to healthcare services when they needed them.

The provider was working within the principles of the MCA. Staff supported people to make decisions although this was not always thoroughly recorded.



Updated 17 July 2018

The service was caring.

People told us staff treated them with dignity and respect. Interactions demonstrated positive relationships had been developed between people and staff.

Care records detailed people�s wishes and preferences around the care and treatment that was provided.

Staff supported people to be as independent as possible.



Updated 17 July 2018

The service was responsive.

Care plans were produced to meet people�s individual support needs and were reviewed on a regular basis.

People and relatives aware of how to make a complaint. When complaints had been raised, appropriate procedures had been followed.

Activities had increased at the service which considered individual needs and abilities.



Updated 17 July 2018

The service was well-led.

Effective quality assurance processes were now in place and used to identify areas of improvements

People, relatives and staff spoke positively of the management team and the improvements they had made. Staff told us they felt supported.

The registered manager sought the views of people and relatives and implemented actions where the service fell short of expectations.