The Spinney Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 66 (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 had a proactive and positive culture of safety based on openness and honesty; staff listened to concerns, investigated and reported safety events and used learning to improve practice.

Leaders recorded incidents electronically, reviewed their circumstances and shared learning through daily handovers, a 7-day handover record and an electronic staff message board. For example, when a person continued to experience falls, staff reviewed their care and shared information on what steps needed to be taken next with the wider team via handovers and message boards. Where needed staff introduced equipment that alerted them when the person moved and might need support. They increased their checks and moved the person to a bedroom where staff could monitor them more closely and respond more quickly. Staff also involved relevant healthcare professionals and relatives. Following these interventions the person’s falls reduced.

The provider evidenced how they learnt lessons from incidents involving medicines, safeguarding, nutrition and supporting people to move safely.
 

The provider worked with people and healthcare partners to establish and maintain safe systems of care. Staff supported continuity, including when people moved into the service or transferred between the home, hospital and other services.

Leaders completed pre-admission assessments and involved people, relatives and relevant professionals. Before people moved into the service, the provider assessed their care and support needs and consulted staff. Leaders used this information to decide whether the service could support each person safely. When people moved in, staff developed care plans and risk assessments, checked medicines against discharge information and arranged a review with the general practitioner.

Staff shared information about changes in people’s needs through daily handovers, care records and electronic messages. Relatives described admissions and hospital transfers as smooth and told us, staff contacted them with relevant updates. One relative told us, “Staff manage movement between the home, hospital and appointments well".

Visiting professionals described good communication with the staff. One professional told us, “I feel welcomed by the service, I received the information I needed. I have no concerns about the support provided by the service.”

The provider worked with people and relevant partners to understand what being safe meant to them and protect them from abuse, neglect and improper treatment. Staff shared safeguarding concerns promptly and appropriately.

People consistently told us they felt safe, and relatives were confident that staff protected their family members. One person told us, “I feel very safe here, staff take care of my safety well.” People and relatives knew who to approach if they were worried and felt confident raising concerns with senior staff or the Registered Manager.

Staff identified, record and report safeguarding concerns. These included body maps for recording injuries and a flowchart explaining how staff should report concerns. Staff had completed safeguarding training and were signed off on relevant policies. Staff recognised different types of abuse and understood their responsibility to record and escalate concerns.

The service took safeguarding concerns seriously. For example, when a person raised a concern regarding an agency worker. Leaders immediately prevented the worker from providing further support, completed an investigation, took appropriate action and informed the relevant relatives and external agencies.

Mental Capacity Act assessments, and Deprivation of Liberty Safeguards were in place and appropriate, where required.

The provider involved people in understanding and managing risks. Staff took a balanced and proportionate approach that supported people to remain safe while respecting their choices and enabling them to do things that mattered to them.

Most people we spoke with said staff involved them in their care plans and risk assessments. Relatives told us, staff consulted them when people’s needs or risks changed. This enabled people and those important to them to contribute to decisions about how risks would be managed.

For example, staff worked with a person and relevant professionals to manage identified risks in a proportionate and least restrictive way. They agreed support that enabled the person to continue doing things that were important to them while reducing avoidable harm. This demonstrated that staff balanced the person’s safety with their rights, choices and independence.

Staff knew where to find people’s risk assessments and described following the agreed guidance. This helped staff understand individual risks and provide support consistently while respecting people’s agreed choices.

The provider did not always detect and control potential risks within the care environment. Some facilities did not consistently support the delivery of safe care.

On the day of our site visit the sluice-room (a room used to clean and dispose of soiled items) door did not have a lock. In the garden, we found 2 potential safety hazards, an area that needed fencing off, and a gate that did not prevent access to the gas shut-off point. This meant people could access areas that should have been kept secure.

While leaders completed frequent walkarounds, environmental audits and external checks they had not been fully effective in identifying and resolving the environmental risks found during the assessment. This meant the provider’s arrangements did not always detect hazards and protect people from the risk of harm.

Leaders responded promptly to our feedback. They addressed the most immediate concerns during the assessment and later provided photographs showing the required environmental work had been completed, reducing the identified risks.

The provider did not always ensure staff were safely recruited or received effective induction, supervision and development. This weakened assurance that all staff were suitable for their roles and consistently supported to maintain safe practice.

Some recruitment records contained gaps. The provider had not carried out the planned 6-month check to confirm that one staff member remained eligible to work in the UK. Another staff member’s file contained character references from friends rather than previous employers and their employment history did not explain a gap in time before they joined the service. This meant the provider could not be assured it had completed all checks needed to employ staff safely. Following onsite feedback, the provider addressed the right-to-work and recruitment-record gaps and supplied evidence of the action taken.

Staff had not received regular individual supervision. This limited leaders’ ability to formally review staff practice and wellbeing, identify gaps in knowledge or competence, agree development actions and check that staff applied their training consistently. Although staff described good day-to-day support, the absence of structured supervision reduced assurance that leaders regularly monitored staff practice and that people consistently received safe and effective support.

Following feedback, the provider introduced structured one-to-one supervisions and provided evidence that these had begun taking place for staff.

People and relatives generally felt there were enough suitably skilled staff.

One person felt staffing levels were sometimes insufficient; however, they told us staff responded quickly when they needed assistance. There were no reports from people regarding delays or missed care. One relative told us, Staff do not take long to get things done.” Relatives we spoke to describedthe staff team as stable and well trained.

Staff spoke positively about their training and the day-to-day support they received from leaders. They told us that effective handovers and communication helped them understand people’s current needs and provide consistent support.

Leaders described using observations, competency assessments and performance-improvement plans when concerns arose regarding staff conduct.

The provider assessed and managed the risk of infection. Staff understood how to identify and control infection risks and how to escalate concerns when necessary.

The provider had an infection prevention and control lead, relevant policies and staff training. Staff described using PPE (personal protective equipment) correctly, disposing of contaminated waste safely and separating soiled laundry. Personal protective equipment and hand-hygiene products were readily available throughout the service.

The home was clean and hygienic. People appeared clean and well cared for, and people and relatives generally described the environment as clean. The domestic staff member understood their responsibilities and had access to the cleaning products and equipment they needed. They completed daily cleaning of high-traffic areas and weekly deep cleaning of people’s bedrooms. Staff recorded maintenance concerns so environmental issues could be addressed.

Kitchen arrangements supported effective food hygiene. Food was covered, dated and stored appropriately. Staff recorded temperatures, followed cleaning schedules and used colour-coded cleaning equipment. The kitchen had achieved a food-hygiene rating of 5.

Staff understood the arrangements they would follow during an outbreak, including displaying appropriate information, isolating affected people and using separate PPE and cleaning supplies.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

During the assessment, we found some protocols for medicines prescribed on a when-required basis (PRN) did not clearly describe person-specific signs, triggers or circumstances which indicated when staff should offer the medicine. This increased the risk of delays in people receiving their medicines when needed.

The medicines trolley was not secured to the wall, which increased the risk of it being moved or accessed inappropriately.

During the observed medicines round, staff did not consistently explain to people what medicines they were receiving. This limited their opportunity to understand their treatment, ask questions and make informed decisions.

Leaders responded immediately to these findings. Following the assessment, the provider supplied updated person-specific when-required medicines protocols and photographic evidence that the medicines trolley had been secured to the wall.

People and relatives were satisfied with the support provided with medicines. One person told us staff were, “Very prompt” when administering their medicines. Relatives did not raise concerns and said staff kept them informed about any changes in their relatives’ medicine.

Staff received medicines training and competency assessments, which the registered manager or senior staff signed off. Electronic reports identified low stock, omitted doses and when-required medicines that needed a protocol or review. Leaders reviewed these reports and followed up repeated refusals with the person’s GP (general practitioner).

When people moved into or returned to the service, 2 appropriately trained staff checked their medicines against discharge information and entered them onto the electronic system. Staff communicated changes promptly and removed discontinued medicines from use, reducing the risk of accidental administration. People received medication reviews through GP rounds.