Thorpedale

About the service

Thorpedale is a residential care home providing personal care to six people at the time of the inspection. The service can support up to seven people.

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

Right Support

The care plans and risk assessments did not always focus on people’s aspirations and did not highlight some key risks for people.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.

People were in the main 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. However, further development was required with clearly documenting any day to day decisions where people did not have capacity.

The service required improvement to ensure people were cared and support in a clean and well-maintained environment that met their sensory and physical needs.

Staff supported people to play an active role in maintaining their own health and wellbeing and enabled people to access specialist health care. People spoke about wanting to have more access to social activities.

Right Care

The provider made sure that there was enough skilled staff to meet people’s needs and keep them safe.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

The manager was proactive in ensuring people had the care and treatment they needed; however, this was not always reflected in care plans.

Right Culture

Professionals and relatives spoke positively about the responsiveness of staff and the management team when supporting people.

The provider had quality assurance systems in place. Most actions were documented, and improvements implemented. However there needed to be further development in capturing lessons learnt particularly where incidents and accidents occurred.

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 good (published 29 September 2017).

Why we inspected

The inspection was prompted in part due to concerns received about another location owned by the same provider. This was in relation to environmental issues, management of safeguarding and good governance. A decision was made for us to inspect and examine those risks at Thorpedale. Thorpedale had not been inspected for some time and a decision was made for us to inspect.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

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

During this comprehensive inspection we found that improvements had been made in all areas that we had previously identified.

Thorpedale provides accommodation, care and support for up to seven people with a learning disability. Some people may have a diagnosis of autistic spectrum disorder. At the time of our inspection there were seven people living at the service.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People felt safe. Staff were knowledgeable with regards to safeguarding people and understood their responsibilities to report concerns. There were effective safeguarding procedures in place and staff had received safeguarding training.

Potential risks to people’s health, safety and wellbeing had been identified and personalised risk assessments were in place. The assessments gave clear guidance to staff on how individual risks to people could be minimised.

People received their medicines as prescribed. There were effective systems in place for the safe storage and management of medicine and regular audits were completed.

There were sufficient numbers of staff on duty to meet people's needs. Staff recruitment was managed safely and robust procedures were followed to ensure that staff were suitable for the role they had been appointed to, prior to commencing work.

Staff received regular supervisions and appraisals and felt supported in their roles. A full induction was completed by staff when they commenced work at the service followed by an ongoing programme of training and development. Staff were positive about the training they received.

People were supported to make decisions about their care and support. Decisions made on behalf of people were in line with the principles of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). Consent was gained from people before any care or support was provided.

A varied, balanced diet was offered at the service and people were very complimentary about the meals provided to them. People were supported to access the services of health and care professionals to maintain their health and wellbeing. Care plans detailed people’s support needs in relation to their health and the support required from the service.

People and their relatives spoke positively about staff. They told us that staff were caring, kind and friendly. Staff engaged people in social conversation and understood their needs and preferences.

People felt involved in deciding the care there were to receive and how this was to be given. People's needs had been assessed prior to admission at the service and individualised care plans took account of their needs, preferences and choices. Care plans and risk assessments had been regularly reviewed and updated to ensure that they were reflective of people's current needs.

People were encouraged and supported to participate in a range of activities and received relevant information regarding the services available to them.

People were aware of the complaints procedure and knew who they could raise concerns with. People felt listened to and that staff were responsive to any concerns or complaints that they may have.

People and staff spoke highly of the registered manager, their ability to manage the service and the positive leadership they demonstrated.

The service had an open culture and staff were committed to delivering high quality care. People were asked for their feedback on the service and comments were encouraged. Robust quality monitoring systems and processes were used effectively to drive improvements in the service and identify where action needed to be taken.

Discussions with the people and the staff and from our observations showed that people were consulted on how they wanted to spend their time, their health and welfare was promoted by sufficient number of well trained staff. The staff on duty knew how to recognise and respond to any concerns relating to abuse and keeping people safe.

We looked at five outcomes and found that the home was meeting all of them. They included how the home ensured the person understood their care and how their health and welfare was promoted. We looked at how medication was administered and stored, how the home ensured that people were assisted to make complaints and finally we looked at how the staff at the home were supported.