Latest Inspection
This is the latest available inspection report for this service, carried out on 29th July 2008. CSCI found this care home to be providing an Good service.
The inspector made no statutory requirements on the home as a result of this inspection
and there were no outstanding actions from the previous inspection report.
For extracts, read the latest CQC inspection for Thorpedale.
What the care home does well All the requirements left at the last inspection had been met and we did not leave any requirements at this inspection. The people who live at Thorpdale are well cared for by dedicated well-trained staff. The home works hard to identify ways of meeting the needs of the residents. For example where residents are unable to articulate their wishes or where the resident has low self esteem preventing them from setting goals the home has referred them to a psychologist who is working with them to improve their quality of life. Another resident who has specific health care needs and is supported through the home working very closely with health care professionals. What has improved since the last inspection? Almost all aspects of care and running of the home had improved since the last inspection. The management and staff have worked very hard to meet the requirement left at the last inspection. The health and welfare of the residents is assured by the home working more closely with health care professionals. The gardens are improved and offer more areas of easy access to those residents who are less mobile. Care plans are improved and contain very good detail to staff on what the residents needs are and how they can be met. They also detail how some resident may be reluctant to participate in activities and how the staff member can offer more direction and guidance. An example of this is the use of picture cards that enable the resident to understand their behaviour and the impact it can have on the other residents. What the care home could do better: This was a positive inspection. The home should continue to develop their person centred care plans and include the residents in all aspects of the running of the home to improve the outcomes for the residents. CARE HOME ADULTS 18-65
Thorpedale 1 Station Approach Chorleywood Rickmansworth Hertfordshire WD3 5AJ Lead Inspector
Marian Byrne Unannounced Inspection 29th July 2008 09:00 Thorpedale DS0000019594.V370390.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Thorpedale DS0000019594.V370390.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Thorpedale DS0000019594.V370390.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Thorpedale Address 1 Station Approach Chorleywood Rickmansworth Hertfordshire WD3 5AJ 01923 284648 01923 284648 kseager@watfordmencap.org.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Watford and District Mencap Keith Philip Seager Care Home 7 Category(ies) of Learning disability over 65 years of age (7), registration, with number Physical disability over 65 years of age (7) of places Thorpedale DS0000019594.V370390.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 28th June 2007 Brief Description of the Service: Thorpedale is a large, two storey, detached house that offers seven single occupancy bedrooms. One double bedroom has been divided to create two single bedrooms. Two of the single occupancy bedrooms are located on the ground floor. There is a kitchen, a lounge/dining room and a laundry that are also situated on the ground floor. The home is surrounded by gardens that have the potential to contain a variety of features such as a patio area, a vegetable patch and raised flowerbeds. There are a variety of shops within a short walking distance and an underground station providing links with central London. Thorpedale DS0000019594.V370390.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes.
One inspector carried out this inspection over a period that covered late morning and early evening. We spent time talking to the people who live in the home and to the staff who work there. Surveys were sent out to the residents and their families. Appropriate records were examined during the site visit to evidence that people’s needs were being safely met by the service. The Registered Manager was not available for most of the inspection. The Deputy Manager and staff assisted us in his absence. What the service does well: What has improved since the last inspection?
Almost all aspects of care and running of the home had improved since the last inspection. The management and staff have worked very hard to meet the requirement left at the last inspection. The health and welfare of the residents is assured by the home working more closely with health care professionals. The gardens are improved and offer more areas of easy access to those residents who are less mobile.
Thorpedale DS0000019594.V370390.R01.S.doc Version 5.2 Page 6 Care plans are improved and contain very good detail to staff on what the residents needs are and how they can be met. They also detail how some resident may be reluctant to participate in activities and how the staff member can offer more direction and guidance. An example of this is the use of picture cards that enable the resident to understand their behaviour and the impact it can have on the other residents. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Thorpedale DS0000019594.V370390.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Thorpedale DS0000019594.V370390.R01.S.doc Version 5.2 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in this home can be sure that their needs will be assessed to ensure the home can provide a good living environment. EVIDENCE: No new admissions have been made since the last inspection. Paperwork on Care plans indicates that full assessments of need are carried out and that the prospective resident has ample opportunity to decide if they like the home and if it meets their needs. All prospective residents are offered reviews at six weeks. Thorpedale DS0000019594.V370390.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in this home can be sure that their needs and choices will be recognised and every effort made to meet them. EVIDENCE: The care plans are good and are person centred. They contain good information on how to meet the needs of the residents. A great deal of work has been done to ensure the home knows as much as possible about the residents and how to make their lives more fulfilled. An example of this is ‘X’ is able to communicate and express their feelings, but does tend to agree with most things, make sure ‘X’ is really happy with her choice’. There is direction on how staff will understand when ‘X’ is happy with their choice. Another resident has difficulty understanding the impact of her behaviour has on other residents, the home is working closely with a psychologist to assist her understanding the impact on others. This includes working with picture cards to show how others may be feeling.
Thorpedale DS0000019594.V370390.R01.S.doc Version 5.2 Page 10 This is what some of the people living at Thorpdale said about living there: ‘the care I receive is very supportive and with input form specialises external agencies there are strategies in place to help me during periods of intensified need’ and ‘due to my decreased mobility some activities are too much for me and therefore I cannot take part in everything on offer’. We observed staff deliver care with care and affection. The residents are facilitated to live as full a life as possible. Thorpedale DS0000019594.V370390.R01.S.doc Version 5.2 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in this home can be sure that they have opportunities for personal and social development, that they will be treated with respect. They have access to the local community. Visitors are welcomed to the home at all reasonable times. They can be sure that the meals are healthy and of good quality. EVIDENCE: The home is in a small village and the residents use the facilities of the village. For example one resident walks to the local shops to buy his paper and to a local café for a coffee as often as their health permits. The residents attend day centres and have other outings and holidays. Visitors are welcomed to the home at all reasonable times. Thorpedale DS0000019594.V370390.R01.S.doc Version 5.2 Page 12 The staff make provision for residents to have contact with their families and friends. We have had surveys back from family members who are clear that they are kept informed on the health and welfare of their family member. Residents are involved in drawing up menus for the home and have indicated that they are happy with the quality of the food they are offered. We say evidence that the residents have their rights respected. An example of this is how one resident likes their room furnished and the articles they keeps that are important to them. We spoke to residents who had recently had a holiday and they told us all about it and how much they enjoyed it. Thorpedale DS0000019594.V370390.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in this home can be sure that their health and welfare will be promoted. EVIDENCE: The health and welfare of the residents is promoted and the person centred care plans indicate that the resident is included in deciding how the care is delivered. One care plan details how a resident is assisted to deal with emotional family phone calls and how they are to be supported afterwards. The home works very closely with health care professionals to ensure optimum health and welfare of the residents. An example of this is one resident who has ongoing health problems that his/her chosen lifestyle may exasperate. The home has ensured that if the chosen lifestyle impacts negatively it will be picked up as soon as possible and intervention offered/made. Medication was stored and administered appropriately. Thorpedale DS0000019594.V370390.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in this home can be sure that their complaints will be listened to and investigated. They will be protected from abuse, neglect and self-harm. EVIDENCE: There are systems in place to ensure the protection of the residents. Staff spoken with were aware of these and assured us that they would act on them if they felt that the residents were at risk. There were no complaints since the last inspection. There is a complaints procedure in place and the residents can be sure that their complaints will be taken seriously and investigated. There were a number of compliments recorded regarding the service from health professionals. Thorpedale DS0000019594.V370390.R01.S.doc Version 5.2 Page 15 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live here can be sure that the home is comfortable, safe, clean and hygienic. EVIDENCE: On the day of the inspection we found the home to be comfortable, safe, clean and hygienic. A great deal of work had been done to improve the grounds to make them more accessible and safe for the residents. The home has acquired funding from a local company to improve the grounds and were part way through the work they intend to do. Thorpedale DS0000019594.V370390.R01.S.doc Version 5.2 Page 16 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in this home can be sure that the staff are appropriately recruited and trained. The staff are well supervised. EVIDENCE: The residents are supported by a well trained dedicated team of managers and care staff. They have extensive training including understanding diabetics, responding to challenging behaviour, health and safety, working with people who have a learning difficulty, risk management and moving and handling. We looked at the file of three staff who had been recruited since the last inspection and they were found to contain all the required information on security and identity including two references and a Criminal Records Bureau clearance prior to them starting work. We found the staff to de dedicated to the residents and there was an easy relationship between them with affection being shown by the residents to the staff. Thorpedale DS0000019594.V370390.R01.S.doc Version 5.2 Page 17 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in this home can be sure that it is run in their best interests. They are consulted on the running of the home. Their health and safety is promoted and protected. EVIDENCE: The Registered Manager was not present for the full inspection however it was clear that the home is run with the welfare of the residents as it priority. They are consulted on the running of the home and on their care. Staff spoken with told us that the management team were very supportive and that they would have not trouble going to them for help or advice. Residents when asked who would they go to if they had a problem indicated that they would go to the office and speak to whoever was there. There was a very relaxed atmosphere in the home.
Thorpedale DS0000019594.V370390.R01.S.doc Version 5.2 Page 18 Records show that the welfare of the residents is protected through the use of risk assessments. All equipment was serviced recently. Chemicals were stored appropriately. There was a fire plan in place and staff spoken with knew what to do in the event of a fire. Thorpedale DS0000019594.V370390.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 x Thorpedale DS0000019594.V370390.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Thorpedale DS0000019594.V370390.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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