The Care Quality Commission
  • Care Home
  • Care home

Archived: Spindrift Care Home Limited

Overall: Requires improvement read more about inspection ratings

36-39 Cleveland Road, Lytham St Annes, Lancashire, FY8 5JH (01253) 737014

Provided and run by:
Spindrift Care Home Limited

All Inspections

2 December 2016

During a routine inspection

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.

To Be Confirmed

During a routine inspection

The service had 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 systems for monitoring the quality of the service were consistent. Staff followed identified aims and objectives. Feedback received from people, their representatives and visiting professionals through the inspection process was positive about the care, the approach of the staff and atmosphere in the home. Some general comments included, “I would recommend the home to anyone it is so homely,” and “This is a good home we were lucky to find it. People are well looked after and staff are so friendly.”

People told us they felt they were safe and well cared for by the staff working at the home. Staff undertook safeguarding training and knew the correct procedures for reporting any suspicion of abuse. Recruitment records showed there were systems in place to ensure staff were suitable to work at the home. Medicines were stored, administered and disposed of safely by staff who were suitably trained.

Senior staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Relevant guidelines were available within the home for all staff to reference. Staff at all levels had an understanding of consent and caring for people without imposing any restrictions.

People were very complementary about the food and the choices available. One person said the food was always “excellent.” Mealtimes were unrushed and people were assisted according to their need. Staff monitored people’s nutritional needs and responded to them. The availability of snacks and beverages allowed for a homelike environment and a flexibility that promoted regular eating and drinking.

People had access to health care professionals when needed. Staff supported people and their relatives to ensure this access was well used and appropriate. A healthcare professional told us staff referred people to them appropriately and followed their advice and guidance to promote good health. There was a variety of activities and opportunities for interaction inside and outside of the home which met individual need. This took account of people’s physical and mental needs. All visitors felt they were welcome to come whenever they wanted to.

People were given information on how to make a complaint and said they were comfortable to raise a concern or complaint if need be. A complaints procedure was available for people to use.

Staff were provided with a training programme which supported them to meet the needs of people. Staffing arrangements ensured staff worked in such numbers, with the appropriate skills so that people’s needs could be met in a timely and safe fashion. Staff felt well supported and on call arrangements ensured suitable management cover.

Staff knew and understood people’s care needs well and there were systems in place for all staff to share information. The care documentation supported staff with clear guidelines and reference to people’s choices and preferences. This ensured staff responded to people on an individual basis.

The home was clean and maintained. However, some areas of the home need attention after a new boiler system had been installed. The registered provider gave us assurances that these matters would be dealt with as a matter of priority. .

Individual risk assessments were undertaken and reflected those associated with people living with dementia and a person centred response to individual risk. Procedures were in place to ensure emergency situations were responded to quickly and safely. Feedback was sought from people, relatives and staff. Staff meetings were being held on a regular basis and staff handover meetings enabled staff to be involved in people’s care and the running of the home. People were encouraged to share their views on a daily basis and satisfaction surveys were being used.

12 February 2014

During an inspection looking at part of the service

This inspection was undertaken to review the improvements the provider had made following our last inspection undertaken on 12th November 2013. During the inspection the provider had been assessed as being non- compliant with meeting people’s nutritional needs. This was because we identified that people were not adequately supported by care staff at mealtimes.

During this inspection we observed lunch was served in a relaxed and unhurried manner. We saw sufficient numbers of staff were being deployed to support people who required assistance to eat their meals. We observed staff members were attentive to the needs of people who required assistance. We saw they were kind, patient and interacted with people they were supporting.

People spoken with after lunch told us they had enjoyed their meal. One person said, “I enjoy all my meals. The food is very good and we are always provided with a choice”.

After lunch we observed care staff completing daily catering records confirming what people had eaten. People at risk of de-hydration were also having their fluid intake recorded. The records were informative and enabled us to identify how staff supported people with their fluid and nutritional intake.

12 November 2013

During a routine inspection

We spoke with six people who lived at the home, two relatives and five members of the staff team. We observed the care and support people received, and spent time with people in the communal lounges of the home and over lunch. People we spoke with told us, 'I am trying to build up my confidence to give me more independence. The care is ok.' A second person told us, 'The care is ok, anyway if I had any problems I would go to the boss, generally speaking.' One relative we spoke with told us, 'We visited various care homes before we decided that this one was the most suitable. Staff will ring us if there is a problem and also keep us up to date with our relative`s daily care.' A second relative commented to us, 'Here, they are marvellous the manager will come and sit with you and they helped me to move my relative in.' Other comments we received were; 'The food here, I like it very much. There is a choice of sausage and mash, pasta or jacket potato and salad. It suits me down to the ground. We have tea or coffee at 2pm and at 8pm we can have coffee, Horlicks, hot chocolate and sandwiches. A little and often, it is an excellent idea.'

We looked at the staffing rotas over a four week period and they showed us there was sufficient staff on duty with a range of skills and experience to meet the needs of the people who lived at the home. However one person we spoke with told us, 'The staff are good but there are not so many on at weekends'. Staff were supported with training and personal development.

Staff we spoke with told us, 'I am well supported by both management and other staff and we work well together as a team. When relatives visit, I bring them up to date with details of care issues and experiences.' 'I am interested in mental health training and everyone here gives me support as and when I need it. There were a range of audits and systems in place to monitor the quality of the service being provided.

17 January 2013

During a routine inspection

We spent time talking to people who lived at the home, visitors and members of the staff team. Some of the people we met were unable to tell us about their experiences of living at the home. However we could see that they were being cared for by a staff team who were motivated and enthusiastic about their work. The staff showed us they were responsive to people's changing needs and showed skill and empathy with the people they were caring for.

When we arrived at the home people it was early morning and people were being supported to take breakfast. We saw there was a flexible routine and people had the choice of where to eat their breakfast. People were being supported with patience and understanding.

24 May 2011

During a routine inspection

People told us they think it is important people feel listened to. "It's important that people have confidence in us as they rely heavily on us to help them".

Some people told us they feel they are always involved in things going on and showed us some of the things they are making as part of the craft group.

Other comments included, "My relative has been here for some time and the staff always make them feel involved and they tell me everything that's going on so I am informed".

People we spoke to told us they are involved in their care plans wherever possible. "They always tell me what's going on and when I have any appointments".

They said they had been kept informed about their care and treatment. "I have a regular appointment at the hospital and the staff always come with me, it's a great comfort you know".

The manager told us all records have been updated and developed during the last six months.

"They take care of all her needs so I don't have to worry about anything'.

People told us they liked the choice of activities and that the activity co-ordinator was "very good at her job".

"There' are daily activities, and if you don't want to join in you don't have to".

The activity coordinator told us they like their job as they get such a good response for most activities and people living there are keen to try most things.

Staff told us they thought the home was very well staffed so they have time to spend with people. We saw this reflected on the staffing rota, which demonstrated a good mix of staff on duty at any time of the day and night.

People told us they thought the food was good, and that they always had a choice if they didn't like something. "I like the choice I can have and I like to eat it on my own, they don't find this a problem", "I think the food is OK, and it's always served nice and hot".

Staff we spoke to told us they felt they had the knowledge and skills to follow procedures if they felt there was any evidence of abusive practice taking place. "I'm confident I would know what to do if I suspected any sort of abusive practice was going on".

Staff we spoke to told us they have specific duties to carry out in respect of maintaining the homes cleanliness. 'We work as part of a team and we have had infection control training as well as having our own policies and procedures to follow".

People we spoke to told us they liked the way they can keep their rooms, and how where possible they have some of their own pieces of furniture or personal effects, which make them, feel more homely.

'I like the way my relative can have their own things around them, I think it is very important".

"Staff responsible for administering meds have all had training and the chemist has been to give us all guidance recently"

Staff told us the medication system has been reviewed and they feel supported by the pharmacist, who provides advice and guidance.

Some people we spoke to said they liked there rooms and liked the way they could bring things with them. "I have my own things which remind me of home"

Some people said they would like their rooms decorated.

Some people told us they like the way they can use the lounge areas and move between them. "I like sitting in the different lounges because you can see what's going on".

Staff we spoke to told us they had all the necessary checks before they started to work in the home. " I went through all the checks before I started work here"

Staff told us they felt they had a good opportunity to train in different areas of care. 'The manager encourages us to go on courses when they come up".

People we spoke to told us "I think this home is well staffed there is always somebody around when you need them".

They told us there have been some changes in the staff team, but there are some staff who have worked in the home for a long time and people have got to know them.

The staff told us they informally get the views of people just by talking to them. 'When you get to chat with people they tell you all sorts of things, especially about thing that have happed in their lives, it can be very interesting".

People we spoke to told us they felt confident they could raise an issue of concern or complaint to the staff or managers if they felt they needed to. "If I am not satisfied about something I just tell them and they get it sorted out for me", "Information is provided about how to make complaints and who to complain to".

"I've never had to complain but I know what to do if I'm not happy about something".