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The Spinney Nursing Home Requires improvement

The provider of this service changed - see old profile

We are carrying out a review of quality at The Spinney Nursing Home. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 7 December 2018

This inspection took place on 18 and 26 September 2018. It was unannounced, which meant no-one knew we were going to inspect the home.

At our last inspection on the 9 June 2016 the location was rated 'good' overall, with all key questions being rated as ‘good’, except for ‘safe’, which was rated as, ‘requires improvement.’ At that time, we identified a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in relation to safe care and treatment. Following the last inspection, we asked the provider to complete an action plan to show us what they would do and by when to improve the key question of safe to at least good.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to safe care and treatment, safeguarding service users from abuse and improper treatment, good governance and fit and proper persons employed.

We discussed our concerns with the registered manager at the time of our inspection and requested an action plan was submitted to the Care Quality Commission within 24 hours of the first day of our inspection, to show how improvements were going to be made in order to protect people’s safety. The action plan was received within the time frame agreed and was found to be satisfactory. The registered manager provided us with an updated action plan on the second day of our inspection and we saw some improvements had been made, However, further improvements were still needed.

The Spinney Nursing Home (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 is located in the village of Upholland. It provides accommodation for up to 35 people requiring help with nursing or personal care needs. The home is situated in its own grounds on a main road position with onsite car parking available. There are three floors served by a passenger lift. Most bedrooms are of single occupancy, although facilities are available for those who prefer to share. A variety of amenities are nearby and public transport is easily accessible.

At the time of our inspection there were 29 people who lived at The Spinney.

The service had a registered manager in post. A registered manager is a person who is 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 registered manager was on duty at the time of our inspection and she was co-operative and helpful throughout.

We found those who lived at The Spinney were not protected by the recruitment practices adopted by the home, as these were not sufficient to ensure all staff were fit to work with vulnerable people. This was a breach of regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We found concerns around fire safety and the general safety of some areas of the home. The management of risks within the environment was insufficient and therefore people were potentially at risk of harm. Some parts of the premises were dirty, which did not promote good infection control practices. The management of medicines was poor. These findings constituted a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We found that a system had been implemented for assessing and monitoring the quality of service provided. However, this was ineffective, as concerns identified during our inspection had not been recognised by the internal auditing system. This was a breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Inspection areas

Safe

Requires improvement

Updated 7 December 2018

The service was not consistently safe.

New employees had not always been recruited safely.

Staff were aware of the provider�s safeguarding policy. However, safeguarding incidents had not always been reported correctly.

The environment needed a thorough clean in some areas and parts of the home were unsafe. Fire risks were evident and the management of medicines was poor.

Emergency plans were in place. People were protected from discrimination and their human rights were promoted.

Effective

Requires improvement

Updated 7 December 2018

The service was not consistently effective.

Access to healthcare professionals was available when required.

Staff received an initial induction and on-going training courses, which enabled them to apply knowledge to support people.

Management and staff had good working knowledge of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) to ensure people's rights were protected.

Caring

Requires improvement

Updated 7 December 2018

The service was not always caring.

Staff respected people�s privacy and dignity in a caring and compassionate way.

Staff were kind and patient in their approach towards those who lived at The Spinney and interactions with people were noted to be caring.

However, this was not always supported by the registered provider, as the maintenance and suitability of the premises did not demonstrate a caring attitude and therefore improvements in this area are needed.

Staff knew people well and responded to their needs appropriately.

Responsive

Good

Updated 7 December 2018

The service was responsive.

Care plans were person centred and included detailed descriptions about people�s care needs.

Assessments were completed prior to agreement of services and they showed a good standard of person centred detail.

Well-led

Requires improvement

Updated 7 December 2018

The service was not consistently well-led.

The auditing systems for assessing and monitoring the service were not effective. However, people were asked for their feedback about the service.

Staff worked in partnership with other professionals to make sure people received appropriate support to meet their needs.

Staff enjoyed their work and told us the management were always available for guidance and support.