The Care Quality Commission
  • Care Home
  • Care home

Archived: Brain Injury Rehabilitation Trust - Spindlebury

Overall: Good read more about inspection ratings

18 Spindlebury Padbrook, Cullompton, Devon, EX15 1SY (01884) 33530

Provided and run by:
Brain Injury Rehabilitation Trust

All Inspections

8 January 2018

During a routine inspection

This announced inspection took place on 8 January 2018. On 15 January 2018 we spoke with members of staff by telephone who were not available at the site visit. We gave the provider 48 hours’ notice as this is a small service where people live independently, and we needed to be sure they would be available to speak with us. At our last inspection in November 2015 the service was rated Good. At this inspection we found the service remained Good.

Spindlebury is registered to provide care and support for up to two people. One person was living at the service at the time of the inspection. The service provides care, accommodation and rehabilitation support for people with an acquired brain injury. The service operates in partnership with The Woodmill, an acute rehabilitation service, which forms part of the nationwide rehabilitation support services provided by The Brain Injury Rehabilitation Trust (BIRT).

Spindlebury is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Why the service is rated …

A registered manager was in place but not available on the day of the inspection. The registered manager is also registered as the manager of two other small community based residential services and The Woodmill, a local acute rehabilitation service. They divide their time between the services. 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 provider employed a multidisciplinary team, which consisted of a clinical psychologist; speech and language therapist; occupational therapists and physiotherapists. People using this service were supported by the multidisciplinary team.

People were protected against the risk of abuse and harm. Staff had a clear understanding of safeguarding and how to protect people from abuse and neglect. People’s medicines were safely managed. However we have made a recommendation that the service follows the National Institute for Health and Care Excellence (NICE) Guideline, Managing Medicines in Care Homes Published 14 March 2014. This was to help the service to ensure they maintained good practice in relation to medicines management. Risks associated with people’s support needs were identified and well managed.

There were sufficient staff available to meet people’s needs. People were supported by caring and compassionate staff that had the skills and knowledge to meet the diverse needs of the people using the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service support this practice. People were supported to maintain good health. They had access to healthcare services and received on going rehabilitation and healthcare support.

Care was well planned and reviewed with the person, to ensure it continued to meet their needs. People had access to a variety of activities and local community amenities.

Quality monitoring systems, and methods of seeking feedback from people were in place to ensure the service continued to be safe and deliver good quality care.

13 November 2015

During a routine inspection

This unannounced inspection was carried out on 13 November 2015. At the last inspection in November 2013 we found the provider met the regulations we looked at.

Spindlebury is registered to provide care and support for up to two people. The service provides care, accommodation and rehabilitation support for people with an acquired brain injury. The service operates in partnership with The Woodmill, an acute rehabilitation service, which forms part of the nationwide rehabilitation support services provided by The Brain Injury Rehabilitation Trust (BIRT). At the time of the inspection there were two people using the service. The service aims to support people to live as independently as possible.

A registered manager was in place and they were present on the day of the inspection. The registered manager is also registered as the manager of two other small community based residential services. They divide their time between the services. 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.’

There was a positive and inclusive culture within the service. People said they liked living at Spindlebury; positive comments were made about the homely environment; friendly staff; good food and activities. One person said, “Staff listen to me…” Another person said, “I like the staff…they help me…they are kind to me…” People participated in a range of different social and therapeutic activities and were supported to access the local community.

Staff knew the people they were supporting and understood the challenges people faced and the choices they had made about their care, support and their daily lives. Risks to people’s wellbeing were well managed and the service encouraged ‘positive risk-taking and promoted people’s independence.

The service had policies and procedures in place in relation to safeguarding people from abuse or neglect. Staff had a clear understanding of safeguarding issues and of what action they would take if they suspected abuse.

There were sufficient staff, with appropriate experience, training and skills to meet people’s needs and promote independence and choice for people using the service. Staff recruitment procedures were thorough and aimed to protect people from unsuitable staff.

People were supported to maintain good health. They had access to healthcare services and received on going healthcare support. Systems for managing medicines were safe. The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals.

People told us they could express their views and opinions and felt listened to. The service had a complaints procedure and people knew how to raise concerns. The procedure was also available in an ‘easy read’ version to help people’s understanding.

There were systems in place to monitor and improve the quality of the service provided. Regular feedback was sought from people using the service, their relatives and staff. One relative described the service as “…fantastic…” Regular checks and audits were undertaken by the registered manager and the provider to ensure the service was safe, well maintained and that good practice was adhered to.

28 November 2013

During a routine inspection

During the inspection we spoke with people who lived at the home, one member of care staff, and some relatives of people who live at the home. We looked at some key records including care plans, risk assessments, annual review records, and policies and procedures. We observed the support offered to the people who live at the home, and looked at the accommodation.

We found that the care and support was delivered in a person centred way, with staff working one to one with people to help them make choices and decisions about their care. People we spoke to were very happy with their care and liked the home and community where they lived. People said they were 'quite happy here" and that they felt they could talk to staff if they had a problem. We saw that people were asked about what they would like to do, and then supported to do it. We saw photos of recent leisure trips that people had been on and they told us how much they had enjoyed it.

A relative we spoke to said they thought the service was 'absolutely fine', that the 'staff are lovely', and that the house was 'absolutely ideal'. They confirmed that they could visit whenever they wanted, and that staff organised regular weekend trips home and an extended trip in the summer for their relative, which they thoroughly enjoyed.

25 January 2013

During a routine inspection

We carried out this unannounced inspection over three hours and spoke with two people who lived at the home. We also spoke with one care staff in detail and one other briefly. We looked at some key records, these included care plans, risk assessments and medication records. This helped us to make a judgement about how well the home was being run.

We found that people's care was being well planned. People were involved in making decisions about their care and treatment. People we spoke with said that they were happy with their care and support. Comments included 'The staff are very nice, they have been good, but I really want to go home now.' Another person said 'I love going out with staff, I hate being bored and I like it when we get out.' We saw that there were regular trips out as well as sessions aimed at providing support and enabling activities of daily living.

We saw that one person had been assessed as being able to self medicate. There were systems in place for people who needed more assistance with medications.

Staff were supported through training and supervision to understand their role and the changing needs of people they worked with.

We saw that records were well maintained, with any accidents or incidents being monitored as well as changes to people's needs and wishes.

6 January 2012

During a routine inspection

We completed an unannounced visit on 6 January 2012, which took place over one hour and 40 minutes. Our visit was part of a planned schedule of inspections.

18 Spindlebury provides a rehabilitation service for people with an acquired brain injury. Some people stay at the home for a set period and then move into community housing with support. However, some people live at the home on a permanent basis. We met with two staff members, who told us that there were two people living at the home. During our visit, we spoke to one person living at the home, as the other person was out taking part in an activity in Exeter. We also looked at care records, quality assurance records and checked how information was shared between staff.

We spoke to one person and asked them how they were supported by staff. They told us how they were involved in day to day decisions about how they spent their time. They told us how they accessed local resources in the community.

A person living at the home was out for the day pursuing an interest that reflected their enjoyment of being outside and active, as recorded in their care plan and highlighted by the staff on duty. We heard from a person living at the home how they were supported to participate in a work placement and take part in craft workshops which they enjoyed.

A person living at the home told us they were satisfied with the maintenance of the home, for example we talked about the standard of decoration and the furniture. We saw that there were items in a communal area that personalised the room, and the person talked to us about individual items and their significance.

During our visit, we saw that a person living at the home was at ease with the staff on duty. We were told that one staff member was on duty per shift and that one person also had the support of an enabler to help ensure they had access to outdoor activities.

A person living at the home told us about how they were involved in making decisions about the day to day running of the home, and we saw that the views of people living at the home were incorporated into their reviews of their care. During our visit, we saw a person had their views about their care listened to and responded to by staff.