Background to this inspection
Updated
30 November 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was carried out by one inspector.
Service and service type:
The Spinney is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The Spinney provides accommodation and personal care for up to three people in one building.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
We gave the service 24 hours’ notice of the inspection site visit because people are often out and we needed to be sure people would be available to speak with us.
What we did before the inspection
We reviewed the information we held about the home, including feedback we had received from the local authority and notifications of significant incidents the registered manager had sent to us.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
The person using the service was not able to tell us their views. We observed how staff interacted with them and looked at their care and medication records. We spoke with two staff, the registered manager and the provider’s Quality Improvement Lead. We looked at one staff recruitment file, staff training records, audits and other records related to the management of the service. We also looked at records about incidents which had happened in the home before our inspection and the actions the provider had taken in response.
After the inspection
We spoke with two relatives of the person who lived in the home and contacted three care staff to gather their views.
Updated
30 November 2019
About the service:
The Spinney provides accommodation and personal care for up to three adults who have a learning disability and/or autism. There was one person living in the home when we inspected.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service:
People were safe and protected from abuse and avoidable harm. There were enough staff to support people. New staff were checked to ensure they were suitable to work in the home. People received their medicines safely and as their doctors had prescribed. The provider responded appropriately to incidents that challenged the service to ensure people were safe.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The staff were trained and skilled to provide people’s care. They understood their responsibilities under the Mental Capacity Act 2005 and people’s rights were respected. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
The staff supported people to prepare their own snacks and drinks and to make healthy eating choices. People’s needs were assessed and appropriate services were included in planning and providing their care to ensure they maintained good health.
People were treated with kindness and respect. The staff spoke to and about people in a respectful way. The staff knew the person living in the home well and gave them prompt support if they were anxious. The staff included the person in decisions about their care and asked for their views.
The person living in the home received person-centred care that was planned and provided to meet their needs. They were supported to see their relatives as they wished and engaged in a range of activities they enjoyed. The provider had a procedure for responding to complaints about the service.
The registered manager was very experienced and aware of their responsibilities. He and the staff were committed to providing people with a high-quality service which met their needs and provided good outcomes. The provider had arranged additional support for the staff and management team in response to challenges the service had faced. The provider had informed us of incidents in the home and met their responsibilities under the duty of candour.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.
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 3 March 2017).
Why we inspected: This was a planned inspection based on the previous rating.
Follow up: We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.