The Spinal Unit Action Group

Updated 11 July 2018

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 took place on 18 May 2018 and was unannounced.

The inspection was conducted by two adult social care inspectors and a Specialist Advisor who had specialist medical knowledge and training of how to support people with spinal injuries.

Before our inspection we reviewed the information we held about the home. This included the Provider Information Return (PIR). A PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also looked at the intelligence the Care Quality Commission had received about the home.

We looked at the care records for four people living at the home, three staff personnel files and records relevant to the quality monitoring of the service. We looked round the home, including people’s bedrooms, the kitchen, bathrooms, garden and the lounge areas. We spoke to three support workers, the registered manager and the deputy manager. We also spoke with a visiting healthcare professional and spoke with five people who lived at the home.

Updated 11 July 2018

This inspection took place on 18 May 2018 and was unannounced.

The Spinal Unit Action Group, is located in a residential area of Southport. Accommodation is provided for up to 12 people who are physically disabled. The home is fully accessible for people who require wheelchair access. It is fitted with appropriate aids and adaptations to support people in their independence and to assist people to move and transfer safely around the home. The home is in close proximity to Birkdale village and public transport links to Southport and Liverpool are within easy reach. At the time of our inspection there were seven people living at the home.

The Spinal Unit Action Group is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

We last inspected the Spinal Unit Action Group on 28 February and 27 July 2017. We found two breaches of the Health and Social Care Act 2008 during this inspection in relation to safe care and treatment and good governance. We also made a recommendation in relation to the recording of complaints.

At this inspection there was 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.

Following the last inspection we asked the provider to complete an action plan to show what they would do and by when to improve the key questions; is the service safe, effective responsive and well led to at least good. During this inspection we saw that improvements had been made. The provider was no longer in breach of these regulations and had improved each key question to a rating of 'good'.

During our last inspection in February and July 2017 we found that risks to people's health and well-being were not always managed appropriately. This was because there was not enough detail in people's risk assessments which explained risk and how to keep the person safe. We found during this inspection that risk assessments had been re-formatted and now contained a high level of detail to help keep people safe from harm.

During our last inspection in February and July 2017 we found that audits and checks were not always consistently taking place to monitor the quality of the service. We found during this inspection the provider had taken appropriate action and a more robust checking and auditing system was in place.

People told us they felt safe living at the home and we received positive comments in relation to this. People also told us there was enough staff on duty at the home and there did appear to be enough staff.

Medication was safely managed, stored and administered. People received their medications on time.

Staff were recruited and selected to work at the home following a robust recruitment procedure. The registered manager retained comprehensive records of each staff member, and had undertaken checks on their character and suitability to work at the home.

The home was clean and tidy. There were provisions of personal protective equipment at the service, and staff were trained in infection control procedures.

Staff were able to describe the process they would follow to ensure that people were protected from harm and abuse. All staff had completed safeguarding training. There was information around the home which described what people should do if they felt they needed to report a concern.

The training matrix showed that staff were trained in all subjects which were mandatory to their role as stated in the provider's training policy. There was additional training in place which was overseen by medical professionals to ensure staff had the correct skills to support people with their clinical needs. New staff with no experience in health and social care were enrolled on an in-depth induction process. Staff received regular supervision and appraisal.

People were supported if they chose to attend healthcare appointments. Some people managed their own appointments themselves.

People were supported to eat and drink in accordance with their needs. Most of the people who lived at the home chose to go out at lunchtime, however there was a main meal provided and kitchens on each floor of the home so people could prepare meals and snacks

The service worked in conjunction with physiotherapists, health nurses to ensure people had effective care and treatment.

Everyone had records in their files relating to external appointments with healthcare professionals such as GP's, opticians, dentists or chiropodists. The outcome of these appointments was recorded in people's records.

Most areas of the home and some people's bedrooms had been refurbished.

The service was operating in accordance with the principles of the Mental Capacity Act (MCA). Everyone who lived at the home had capacity to make their own decisions.

We observed kind and caring interactions between staff and people who lived at the home.

There were positive examples of person centred information in peoples care plans. The new documentation was more in depth with regards to finding out more information about people, their likes, dislikes and how they wanted their support to be delivered.

There was a procedure in place to document and address complaints. Everyone we spoke with said they knew how to complain. The complaints procedure was displayed in the communal areas of the home.

Staff were aware of how to support people to manage their end of life wishes. Most of the people who came to the Spinal Unit Action Group came to aide their recovery and eventually moved back to their own homes once a period of rehabilitation had taken place.

Everyone knew who the registered manager was. The registered manager had been in post at the home for a long time alongside the deputy manager.