The Spinney Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff used care plans, risk assessments and “About Me” profiles to record people’s assessed needs, daily routines, preferences, communication and the people important to them. People, relatives and relevant professionals contributed to these assessments. When people experienced communication difficulties or could not provide all the information themselves, staff supported them to contribute verbally and sought information from those who knew them well. This helped staff understand how to provide care in accordance with people’s assessed needs.

Leaders used a resident-of-the-day system to review people’s care plans and risk assessments. The service invited relatives to review the information and identify anything that needed changing. Staff used care records and handovers to remain informed when people’s needs changed. People and relatives generally said staff understood their needs, respected their preferences and involved them in reviews.

The provider planned and delivered people’s care and treatment with them, including what was important to them. Staff followed legislation, current evidence-based practice and recognised standards.

Leaders kept their knowledge current through training, updated policies, information from commissioners and guidance shared by the local authority. They communicated changes to staff through training, handovers and electronic messages. People and relatives generally felt staff were trained, competent and understood people’s individual and complex needs.

Staff followed recognised guidance when supporting people with nutrition and swallowing needs. Information about people’s dietary requirements, allergies, preferences, prescribed supplements, fluid thickeners and texture-modified diets was available in care plans, the kitchen and on the meal trolley. The service used Malnutrition Universal Screening Tool (MUST) guidance to clinically support people to manage weight. During the lunchtime observation, staff followed people’s assessed levels under the International Dysphagia Diet Standardisation Initiative (IDDSI). This reduced the risk of people receiving food or drinks that were unsafe for them.

Daily menus included 2 main meal options, but people were not limited to these and could request an alternative if neither met their preferences. Snacks and drinks were available when people wanted them. People generally spoke positively about the food and confirmed they could make choices. Staff offered fortified foods and additional support when people experienced reduced appetites or unintentional weight loss.

Staff also followed Waterlow guidance to support people with skin integrity and repositioning. Staff completed skin checks during personal care and followed peoples assessed repositioning schedules. For example, the service worked with district nurses to support a person with a significant pressure wound. Staff followed the recommended dressing plan, recorded changes and used photographs to monitor healing. The person’s wound improved significantly, demonstrating that staff implemented professional guidance and monitored the effectiveness of the treatment.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing assessments of their needs when they moved between different services.

Staff communicated changes in people’s health, risks and professional guidance across the service. This helped staff remain informed and implement agreed care consistently across different shifts. Relatives said staff kept them updated about appointments, changes in people’s needs and the outcomes of healthcare involvement.

The provider worked well with GPs, district nurses, physiotherapists, occupational therapists, speech and language therapists and social workers. Leaders recorded professional involvement and updated people’s care plans when recommendations changed.

One professional described effective partnership working and said, “Staff know people well and respond appropriately to professional guidance.” For example, staff identified that food relatives had brought into the home was not suitable for a person’s assessed dietary needs and may have placed them at risk. Staff sought advice from the relevant professional and provided detailed information about the person’s communication needs, preferences and dietary requirements. This led to clinical guidance being provided to the home, which enabled staff to give relatives clear, safe advice about suitable food for the person. When leaders needed clarification about a person’s care or personal circumstances, they consulted colleagues who knew the person well and provided accurate information rather than making assumptions. A professional told us that leaders’ willingness to check information rather than guess was not something they experienced everywhere. Another visiting professional felt welcomed and described communication with the service as good. They were satisfied with the support provided and raised no concerns. This feedback demonstrated that staff collaborated openly with professionals and shared relevant information to support coordinated care and treatment.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People had access to a weekly GP ward round. Staff did not wait for the planned ward round when people required support and contacted healthcare professionals or emergency services when people’s health deteriorated. For example, staff recognised signs and symptoms of sepsis and immediately arranged hospital treatment. This ensured the person received urgent medical care.

Staff understood how people communicated pain, illness or distress. One staff member explained that, for people who did not communicate verbally, they looked for changes in mood, facial expressions and behaviour. This helped staff identify when people might require additional support or healthcare intervention.

Relatives described staff arranging support from general practitioners, district nurses, hospitals and specialist services. One relative said, “Staff act positively on requests relating to my family member’s teeth, nails and pain relief.” Another relative said staff encouraged and accompanied their relative to hospital and provided nutritional drinks when their appetite reduced and arranged chiropody support when requested.

Staff encouraged people to maintain their mobility and participate in activities. One staff member told us, “We encourage people who appear lethargic to become more active, including walking in the garden or taking part in games and activities."

Staff supported healthier choices while respecting people’s rights and preferences. For example, when a person’s clinical requirements increased, staff involved the person and their relative and sought advice from healthcare professionals. Staff supported the person to choose more suitable meals and snacks without unnecessarily restricting their choices. Meaning clinical needs subsequently reduced.

The provider routinely monitored people’s care and treatment and generally used the findings to improve outcomes. Staff involved people and those important to them in reviewing whether their care continued to meet their needs and expectations.

Leaders completed resident-of-the-day reviews for 2 people each week. These included reviewing care plans, risk assessments and medicines. Leaders spoke with people about whether they were happy with their care and whether they wanted anything to change. They also invited relatives to review care plans and contribute information about people’s needs, preferences and desired outcomes. Staff updated records and shared changes through handovers and electronic messages.

Leaders monitored incidents, falls, skin integrity, medicines and changes in people’s health. They involved relevant healthcare professionals when care or treatment was not working. For example, after a hospital admission, one person was advised to follow a different diet. They did not enjoy it and began eating less. Staff sought a specialist reassessment and updated the person’s care plan following professional advice. The person then received a more suitable diet and started finishing their meals. This showed that staff recognised when care was not meeting the person’s needs and took action to improve the outcome.

The provider supported people to understand their rights around consent and respected their decisions when delivering care and treatment.

People told us staff listened to their views and involved them in planning their care. Relatives told us staff involved them appropriately when people’s needs changed, while continuing to recognise the person’s own rights and wishes.

Staff described explaining the care or treatment they intended to provide and seeking consent before supporting people with personal care. They understood that people with capacity could refuse support or make decisions other people might consider unwise. For example, when a person declined care, staff provided relevant information and encouragement to support an informed decision. Staff understood they could not force people to accept care or treatment.

Staff made adjustments to help people understand information and participate in decisions. For example, when a person could not participate in reading or writing, a staff member sat with them, verbally explained the consent information and recorded their responses. This enabled the person to contribute directly to their care planning rather than relying on others to make decisions for them.

Where there were concerns about a person’s ability to make a particular decision, leaders described completing capacity assessments and involving relevant people and representatives where necessary. The service considered less restrictive options and kept people involved as far as possible.