Background to this inspection
Updated
22 February 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection team consisted of two adult social care inspectors and an inspection manager.
Prior to this inspection, we reviewed all the information we held about the service, including data about safeguarding and statutory notifications. Statutory notifications are submitted to the Care Quality Commission and tell us about important events the provider is required to send us. We spoke with the local authority, to gain their feedback about the care people received. This helped us to gain a balanced overview of what people experienced accessing the service.
Not everyone shared their experiences of life at the home. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We observed how staff interacted with people who lived at the home and how people were supported during meal times and during individual tasks and activities.
We spoke with a range of people about Spindrift Care Home. They included seven people who lived at the home and three relatives. We spoke with the manager, deputy manager, the owner and nine staff.
We looked around the home to make sure it was a safe and comfortable environment and observed how staff helped and communicated with people who lived there. We checked nine care documents in relation to people who lived at the home. We looked at six staff files and reviewed records about staff training and support.
We looked at documentation related to the management and safety of the home. This included health and safety certification, staff rotas, policies and procedures.
Updated
22 February 2017
The inspection visit at Spindrift Care Home took place on 02, 05, 07 December 2016 & 12 January 2017 and was unannounced on the dates in December 2016.
Spindrift Care Home is registered as a care home service with the Care Quality Commission. It is located close to Lytham town centre, providing access to a range of community facilities and services. The home is registered to provide personal care for up to 34 people. Spindrift Care Home cares for the needs of people with dementia, older people, people with a physical disability and people with learning disabilities or with autistic spectrum disorder. The communal areas of the home include three separate lounges, a dining room and a conservatory that leads out to a rear, paved patio.
The service did not have a registered manager. 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. A manager has been in post since March 2016. They have commenced the process to apply to become registered manager.
At the last inspection, we found the provider was meeting the requirements of the regulations. We rated the service as ‘Good’.
During this inspection, we found concerns in several areas as set out in this report. The provider was no longer meeting the requirements of the regulations.
We looked at the recruitment of six staff members. We found appropriate checks had not always been undertaken before they had commenced their employment to confirm they were safe to work with vulnerable people. This was in breach of regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
We found not all staff had received appropriate training to ensure they had the knowledge and skills to meet people’s needs. Staff had not received a regular appraisal. The provider had not ensured a sufficient number of suitably qualified, skilled and experienced staff were deployed at all times. This was in breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
We found risk assessments and measures to reduce risks to people who lived at the home were not always up to date and reflective of people’s current needs. We found the provider had implemented a business continuity plan, however this was not up to date and required review. Personal Emergency Evacuation Plans were not in place for everyone who lived at the home. We found handwashing facilities were not sufficient in each area of the home. The provider had not undertaken any analysis of accident and incidents to reduce the risk of recurrence. The matters were in breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The provider was not working within the principles of the Mental Capacity Act 2005. The provider had not undertaken any assessment of people’s capacity to make decisions. Decisions had been made on people’s behalf without ensuring they were in the best interests of the person. People were restricted regardless of their capacity. This was in breach of regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
People’s care needs were not thoroughly assessed. Plans of care had not been designed with the person to meet people’s needs and achieve their preferences. This was in breach of regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The provider was not effectively operating systems designed to assess, monitor and improve the quality of the service provided. The provider had not maintained an accurate, complete and up to date record of the care people received. The provider had not sought, gathered and taken into account the views and experiences of people, their relatives and staff about how the service was delivered. This was in breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
We looked at all areas of the home, including bedrooms, communal areas, toilets, bathrooms and the kitchen. We found these areas were generally clean, tidy, and maintained. However, there were areas of the home which required maintenance. We have made a recommendation about this.
We have made a recommendation about the home not being suitably adapted to meet the needs of people living with dementia.
We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept with appropriate arrangements for storing in place.
People who were able told us they were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration.
The provider supported people to access external healthcare services, as required.
People we spoke with told us they were pleased to be living at the home and staff were pleasant, helpful and caring. We observed staff treated people with kindness and compassion.
The manager had undertaken a significant amount of work to gather and record people’s preferences with regard to activities and meaningful stimulation. People spoke positively about the range of activities available to them.
The provider had a suitable complaints procedure. No formal complaints had been received by the service in the last 12 months
People were protected from the risk of abuse because staff understood how to identify and report it.
People we spoke with told us they were happy with the management of the home. However, visiting relatives and staff all gave us mixed feedback about the management team. The manager had been in post for around nine months when we carried out this inspection. During that time, the service had experienced a significant change in culture.
During our inspection, the manager and provider were receptive to our concerns and the feedback we gave them. They took action promptly to address immediate safety concerns and immediately began to improve the quality of the service provided.
We have found a number of breaches of the Health and Social Care Act 2008. You can see what action we have told the provider to take at the back of the full version of the report.