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 encoura

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.

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.

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.

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.