Archived: Spurfield House Residential Home

When we arrived at Spurfield House we found decorators were busy decorating the main entrance hallway and staircase. Many other areas of the home had been decorated in recent weeks and new flooring, furniture and furnishings have been purchased and some areas refurbished. The manager showed us the schedule of further work to be completed in the near future including decoration of the corridors on the upper floors and decoration and some refurbishment of toilets and bathrooms. We were also assured that the exterior of the house will be repainted when the weather improves next spring.

We talked to one member of staff and four people who lived at Spurfield House about the works being carried out and they told us how pleased they were with the improvements. They said they had been consulted over the choice of decorations and furnishings and they were delighted with the results so far. They said it made Spurfield House a much nicer place to live.

We looked at three care plan files and found that all care plans had been updated since our last visit and provided a good level of detail about each person's needs. People told us they had been consulted about their care plans and had been offered a copy. They said they were happy with the information in their care plans.

We also looked at the risk assessments completed for the home. We found that the home had received specialist support to review all risk assessments, including assessments for smoking risks. The new risk assessments were detailed and showed the actions identified to reduce or eliminate risks.

We looked at the recruitment files for one new member of staff recruited since our last inspection and found that all required checks and references had been obtained. This means that the home had good evidence to show that they had taken care to ensure new staff were suitable for the job and that people would be in safe hands.

We also looked at the training offered to all staff. We found that there were eleven permanent staff working in the home including the manager. Four had already gained a nationally recognised qualification known as NVQ's. Three staff were in the process of obtaining this qualification. When they have achieved this qualification there will be a satisfactory ratio of suitably qualified staff working in the home, although the ratio at the time of this inspection was low. One member of staff we talked to said there was a happy staff team and good teamwork. No agency staff had been used in recent months, and the home had a team of bank staff who could provide cover for holidays and sickness, although we heard that this had not been necessary recently. We also heard that staffing levels had improved in recent months.

The four people we talked to who lived in the home told us they were happy living there. They were happy with the meals provided and the support they received. We heard many examples of how they had joined in with things going on in the local community, and how the local community had supported the home.

We looked at three care plan files and talked to each person the files related to. New care plan recording forms had recently been completed but we found that people had not been fully involved from the beginning of the process. People told us they knew they would be consulted in the near future to agree the content of the plans. The manager told us that when they had spoken to some people about their care plans she had been concerned that the way the plans had been written had resulted in some people not being able to fully understand or engage in the process. The manager was considering ways of improving the care plans to provide clearer and better information.

The manager and care workers described some of the individual support needs and strategies they followed with people. We found this information had not always been documented in the care plans, or agreed with the person. Some individual risks, for example, the risks to individuals who smoked, had not been fully assessed, and the risk assessments did not explain fully the measures that had been considered in order to minimise those risks.

Since our last review of the service the standard of hygiene had improved. A member of staff had been recruited with specific responsibility for cleanliness and hygiene. All areas of the home were clean and free from odours.

Storage and administration of medicines had also improved. Each person had a secure cabinet in their room where their supply of medicines was stored for that month. This enabled care workers to give people individual support with medication, and, where possible, to help people to administer their own medicines. All unused medicines were returned to the pharmacy at the end of each month. Good recording systems were in place and monitoring systems were used to ensure each person received their medication at the correct time. Care workers had received training on the safe administration of medicines.

We looked around the building and found that some furniture had been replaced since our last visit. However, many areas of the home still required redecoration or maintenance. A list of works needed had been drawn up by the manager and a service manager, but we saw no evidence to show when the work will be carried out. Some essential work was necessary in the kitchen to maintain hygiene and safety standards and we were told that the manager had authority to get the work completed as a matter of priority.

We visited the local offices of Guinness Care and Support to look at staff recruitment and training records held there. We found that the provider had not always followed robust or safe recruitment procedures. Some new staff had started working with vulnerable people before the provider had satisfactory evidence in place to show they were suitable for the job.

Training records showed that staff had received a good level of induction and training. They have received training on all required health and safety topics, and also on topics relevant to the health and support needs of the people living at Spurfield House. The level of staff who held a relevant qualification was low. Out of twelve staff employed there only three held a relevant qualification, while another three were in the process of working towards a qualification. We were told that the providers were about to put another batch of staff through training in the very near future.

We found that people were living in a warm and comfortable environment. However, some areas, particularly some of the bedrooms, appeared untidy and in need of redecoration. Some furnishings were of poor quality, stained or damaged.