CQC report explained · a residential care home
What the CQC found at Thorpedale
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Some risk assessments did not explain how people should be supported safely. Inspectors also found mould, staining, strong odours, dirty equipment and damage to the carpet.
- Effective?
- Good
- The report does not give a separate Effective rating in this inspection. Inspectors noted that staff supported people's health and worked with health professionals, but some care plans did not reflect the care being provided.
- Caring?
- Good
- The report does not give a separate Caring rating in this inspection. People, relatives and professionals described staff as kind, caring and responsive, although some people wanted more help to build independence.
- Responsive?
- Good
- The report does not give a separate Responsive rating in this inspection. People were involved in discussions about the service, but some requests for changes and more activities were not followed through.
- Well-led?
- Requires improvement
- Quality checks and improvement plans did not always identify or deal with problems. The management team had not consistently reviewed incidents and medicine errors for wider lessons.
What inspectors found, January 2023
Rated Requires Improvement; inspectors found enough staff and kind, responsive support, but risks, the environment and management checks were not always handled well.
This was an unannounced inspection on 14 November 2022. Two inspectors spoke with people living in the home, relatives, staff and health and social care professionals. They also reviewed care plans, medicines records, staff files and records about the management of the home.
The home was supporting six people and could support up to seven. Inspectors found enough staff, suitable recruitment checks, trained staff and support with medicines and safeguarding. Relatives and professionals said people were safe and staff were kind and responsive.
However, some risk assessments and care plans did not explain clearly how people should be supported. Parts of the home were dirty or in poor repair. Audits and improvement plans had not always led to action, and lessons from incidents, including medicine errors, were not being used effectively.
The overall rating was Requires Improvement. Safe and Well-led were both rated Requires Improvement. The previous overall rating and both of these key question ratings were Good, published on 29 September 2017.
Enough staff
Inspectors found enough staff to meet people's needs and keep them safe. People did not have to wait when they needed support.
“We observed people being supported when they required it and did not need to wait for their needs to be met.” from the report
Safeguarding
Staff had training about recognising and reporting abuse and understood how to act. The home also worked with other agencies.
“People were supported by staff who had training on how to recognise and report abuse and they knew how to apply it.” from the report
Medicine support
Medicine care plans were detailed, staff were trained, and competency checks were completed. Staff also worked with health professionals to reduce medicines where appropriate.
“The service worked alongside health professionals to reduce medicines no longer required and to implement non-drug therapies and practical ways of supporting people instead.” from the report
Kind and responsive staff
People, relatives and professionals gave positive feedback about staff and management. The manager was visible and approachable.
“Professionals and relatives spoke positively about the responsiveness of staff and the management team when supporting people.” from the report
Risk records were incomplete
seriousSome risks were identified but the records did not explain clearly how staff should support the person. Inspectors said this could increase the risk of harm.
“People's risk assessments in places lacked the information required to support them.” from the report
Poor home condition
seriousInspectors found mould, stained flooring, dirty equipment, strong odours and damage to the stairs carpet. Some repairs identified earlier had still not been completed.
“We found parts of the home in a poor state of repair, and in need of cleaning.” from the report
Incidents not fully reviewed
needs fixingStaff reported incidents, but the management team did not formally discuss accidents and incidents to make sure lessons were learned. Medicine errors had not been included in the improvement plan.
“The manager acknowledged that the incident and accidents were not formally discussed in the service to allow staff to reflect back on the lessons learnt.” from the report
Improvement plans did not capture everything
needs fixingAudits and action plans did not always identify or deal with known problems. Some requests from people about changes to the service had not been acted on.
“There were key actions that had been identified that had not been captured or actioned.” from the report
More independence and activities wanted
minorPeople wanted more opportunities to learn skills, develop independence, try new things and take part in social activities and their local community.
“People spoke about wanting to have more access to social activities.” from the report
- 01Which repairs and cleaning improvements identified by the inspection have now been completed, and how are they checked?
- 02How do you make sure every person's risk assessment explains exactly how staff should support them?
- 03How are medicine errors and other incidents now reviewed for patterns and lessons?
- 04What changes have been made in response to people's requests for more activities and greater independence?
- 05How are people's day-to-day mental capacity decisions recorded and reviewed?
This inspection focused on Safe and Well-led; the report gives no separate ratings for Effective, Caring or Responsive. This explanation was written from the published report of 11 January 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, September 2017
Thorpedale was rated Good; inspectors found safe, kind and personalised care, with improvements made since the previous inspection.
This was an unannounced comprehensive inspection on 16 June 2017. One inspector spoke with people living at the home, care workers and managers. They observed care, reviewed three people's care records and risk assessments, checked medicines records, and reviewed staff and quality monitoring records.
The home supported seven people with learning disabilities, with places for up to seven people. Inspectors found people felt safe, medicines were managed properly, staffing levels were enough, and staff had suitable training and support.
People were involved in decisions about their care. Staff respected people's privacy, choices and dignity. Care plans were personalised and activities were based on people's interests. The home had effective complaints and quality monitoring systems.
The overall rating and all five question ratings were Good. The report says the problems found at the December 2015 inspection, involving risk assessments and consent under the Mental Capacity Act, had been addressed.
Personalised risk support
Risks to people's health, safety and wellbeing were identified. Staff had clear guidance on how to reduce those risks while supporting people's independence.
“Potential risks to people's health, safety and well-being had been identified and personalised risk assessments were in place for each person who lived in the service.” from the report
Safe medicines
Medicines records had no gaps or omissions. Medicines were stored securely and checked through regular audits.
“These robust systems helped to ensure that medicine errors were minimised, and that people received their medicines safely and at the right time.” from the report
Respect and kindness
Staff built positive relationships with people and understood their preferences. Inspectors observed patient, friendly and respectful support.
“We observed interactions between staff and people and found these to be caring, friendly and respectful.” from the report
Choice and activities
People helped shape their care plans and were supported to take part in activities that suited their interests.
“People were encouraged and supported to participate in a range of activities, based upon their preferences.” from the report
Quality monitoring
The home used audits, feedback and action plans to identify issues and track improvements.
“This demonstrated how the registered manager used the audit process to drive improvements at the service and ensure actions were completed.” from the report
Inspectors raised no specific concerns in this report.
- 01How are each person's risk assessments and care plans reviewed now, and how are changes in health or needs recorded?
- 02How do you check that consent is obtained and that Mental Capacity Act assessments and best-interest decisions remain up to date?
- 03How often are medicines audits completed, and how are any errors or discrepancies followed up?
- 04What activities are currently available, and how are they matched to each person's interests and choices?
- 05How can residents and relatives raise concerns, and how are these recorded and resolved?
This was an unannounced comprehensive inspection covering all five questions, with previous concerns about risk assessments and Mental Capacity Act requirements checked and found to have been addressed. This explanation was written from the published report of 29 September 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Thorpedale
3 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- January 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2017Goodup from Requires improvementSafe: GoodWell-led: Good
- April 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 27 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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Most charge £980 to £1,300 a week. 82 can care for a couple. 12 years' experience on average.
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