The Spinnies

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

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 has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had processes in place to ensure people’s needs were assessed in a timely and holistic way, and staff were knowledgeable about those needs. However, care plans did not always fully reflect people’s needs or provide clear guidance for staff. For example, some care plans stated people required staff observations at specific intervals during the night, yet there were no accompanying night-time care plans and no clear timeframes or instructions on how these checks should be completed. Additionally, for people requiring support with continence care, care plans referred only to “regular checks,” which did not promote person‑centred care or uphold dignity.

We did not find any evidence of harm during the assessment, and staff demonstrated good knowledge of people’s needs despite the lack of written guidance. The provider acted on this feedback during the assessment and ensured care plans were updated.

The provider planned and delivered people’s care and treatment collaboratively with them, ensuring it reflected what was important and mattered to each individual. Care was delivered in line with legislation and current evidence‑based best practice. A range of nationally recognised risk assessment tools were used to identify risks and support staff to plan safe and effective care. For example, a validated wound assessment tool was used to identify people at risk, and a nutritional risk assessment tool helped highlight individuals who may be at risk of malnutrition or choking. The use of these tools ensured risks were promptly identified and provided clear guidance to staff.

The provider also sought input from external professionals when appropriate to support people’s needs. One professional told us, “The work the provider has put into supporting [Name] and having their needs assessed with the support of the speech and language therapist has been really good.”

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. External professionals we spoke with told us the provider and staff were responsive to their recommendations and worked well with them when changes to people’s care were needed. One professional said, “Credit must go to the deputy manager, they raise issues quickly and their communication is excellent.”

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. During the assessment we saw people supported in person centred ways to achieve their goals including supporting living healthier lives. For example, people were encouraged and supported to improve mobility and exercise levels with walks in the local community. Other people were supported to access horse riding lessons.

The provider did not always routinely monitor people’s care and treatment to drive continuous improvement. They did not consistently ensure that outcomes were positive, reliable, or aligned with clinical expectations and the expectations of the people using the service. For example, for individuals supported at night with sensor equipment, care plans stated that staff should record that the equipment was functioning during checks and that they must carry a monitor with them at all times. However, staff records did not demonstrate whether these checks had been carried out or when staff were in possession of the monitor. Quality monitoring processes had also failed to identify this gap in record‑keeping.

Despite these issues, there was no evidence that anyone had come to harm as a result of the missing documentation, and the provider took immediate action to support staff to improve their record‑keeping practices.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff demonstrated a clear awareness of how each person expressed agreement, refusal or uncertainty, and they adapted their approach to ensure people were fully involved in decisions about their care.

Communication plans were detailed and person‑centred, outlining the gestures, signs, symbols or verbal cues each individual used. Staff were familiar with these plans and applied them reliably in day‑to‑day practice. Observations throughout the assessment showed staff checking in with people before offering support, explaining what they were doing and waiting for clear indications of consent before proceeding. This included using visual prompts, simple language, or giving people additional time to process information when needed.

The home had easy read documentation available for all interactions with people such as best interest decision and review meetings which ensured people were able to fully be involved in decision making.