• Care Home
  • Care home

Thorpedale

Overall: Requires improvement read more about inspection ratings

Station Approach, Homefield Road, Chorleywood, Hertfordshire, WD3 5QJ (01923) 969154

Provided and run by:
Watford And District Mencap Society

All Inspections

14 November 2022

During an inspection looking at part of the service

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.

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.

16 June 2017

During a routine inspection

This inspection took place on 16 June 2017 and it was unannounced. At the last comprehensive inspection in December 2015, we asked the provider to take action to make improvements to the assessment of risks to people living in the service and the information provided to staff in order to mitigate those risks. We also found a lack of evidence with regards to people giving their consent to receiving care and treatment at the service and people’s care had not been provided in accordance with the requirements of the Mental Capacity Act 2005 (MCA). This was because assessments had not been carried out to check whether people had mental capacity to make informed decisions about specific aspects of their care. We received a provider action plan which stated the service would meet the regulations by August 2016.

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.

7 December 2015

During a routine inspection

We carried out an unannounced inspection on 7 December 2015.

The service provides care and support for up to 7 people living with learning disabilities and/or autistic spectrum conditions. There were 7 people being supported by people at the time of the inspection.

There is 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 provider had effective systems in place and staff had been trained on how to safeguard people. There were individual risk assessments for each person. However, these did not give sufficient guidance to staff on how risks to people could be minimised. The risk assessments also did not provide a safe balance between enabling people to make choices about their care and effective risk management. The provider had effective recruitment processes in place and there was sufficient staff to support people safely. People’s medicines had been managed safely and administered in a timely manner.

There was no evidence to show that people consented to their care and support. Also, people’s care had not been provided in accordance with the requirements of the Mental Capacity Act 2005 (MCA) because assessments had not been carried out to check whether people had mental capacity to make informed decisions about specific aspects of their care. Staff had received effective training, support and supervision that enabled them to provide appropriate care to people who used the service.

People’s needs had been assessed and they had care plans that took account of their individual needs, preferences and choices. They were supported to have sufficient food and drinks, and had access to other health and social care services when required in order to maintain their health and wellbeing.

Staff were kind and caring towards people they supported. They treated people with respect and supported them to maintain their independence as much as possible. People had been supported to pursue their hobbies and interests in order to live happy and fulfilled lives.

The provider had a formal process for handling complaints and people had been given this information in a format they could understand. People and their representatives had been encouraged to provide feedback about the quality of the service provided and their comments had been acted on.

The registered manager provided effective support to the staff. They had effectively used the provider’s quality monitoring processes in order to drive improvements.

During this inspection, we found the service to be in breach of some of the regulations. You can see what action we told the provider to take at the back of the full version of the report.

10 January 2014

During a routine inspection

We spoke to or made contact with all the people who lived at Thorpedale. The people we spoke with told us that they were happy with their life at Thorpedale. They said that they had a member of staff who was their key worker and that they had a good relationship with them. We saw during our visit that the people had been offered choices on how to spend their day. One person who was not well had been cared for in their room, as they did not want to leave their room.

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.

28 January 2013

During a routine inspection

The people who lived at Thorpedale told us that they liked living there and that the staff were nice and that they were easy to talk to. We were told that the manger was nice and was usually present in the home. They said that the staff helped them to do nice things. One person was taken to pursue their hobby once a week and told us all about it and how much they loved doing it. Another person was waiting to go home to visit for a few days, this was something they did regularly. We found that those people who did not have family to support them had access to an advocate to represent their views.

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.

24 November 2011

During a routine inspection

On 24 November 2011 we were shown around the home by a person who said that people living there made their own choices about their care and how they spend their days. They said that the staff supported them to express their own views and helped them to understand any treatment which might be recommended by health services.

Other people said that staff respected their choices and their privacy. People we spoke with said they were very happy living in the home and one person said they loved it at Thorpedale and had lots of things they enjoyed doing every day, including cooking the food they grew in the garden. One person said they had told staff they would like a computer and were now attending a computer course for beginners so that they could achieve this aim. One person told us that they would tell the manager or staff if they had any concerns and said that all the staff listened to whatever they wanted to tell them. They also said they knew all about fire safety and took part in fire drills. The person said that they collected their own money and managed it with staff support. The people we spoke with during our visit all said the staff were really good and always helped them in the way they wanted. They said they thought there were enough staff on duty to enable them to take part in their chosen activities. The people we spoke with said that they were involved in making decisions about any changes which might be made at the home such as having a new kitchen installed.