Spennymoor Care Home Limited

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 good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 63 (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 did not always have a proactive and positive culture of safety based on openness and honesty. Staff did not always listen to concerns about safety and did not always investigate and report safety events. Lessons were not always learnt to continually identify and embed good practice.

The registered manager said they didn’t keep a central log of accidents and incidents (although an accident book was maintained) and despite incidents such as falls, no review of these took place to identify patterns and trends to support a lessons learned approach.

However people told us if they ever raised concerns, they were addressed by staff and the management team. One relative said, “I have had to raise a few things before and they were immediately sorted out, they took it seriously.” We also saw learning from incidents was discussed in supervision and team meetings.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Staff undertook pre-admission assessments and considered this information alongside any available social worker assessments and medical information, to ensure the service could meet people’s needs. Relatives told us they were involved with the assessments process, although this was not always clearly documented. The provider told us people were involved with this process, although hadn’t signed the assessment paperwork. We were assured this would be completed moving forwards.

People who used the service and their relatives said the home was safe. One person said, “I do feel safe, it is having people around you [that makes you feel safe].” A relative also said, “Every time we come, we know exactly where [person] is. The staff speak very positively about [person] and know what they can and can’t do.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

There was a safeguarding policy and procedure in place which explained what staff should do if they experienced any abuse. Staff had completed safeguarding training and understood how to report concerns. A member of staff said, “I haven’t seen any incidents. Neglect would be a safeguarding concern. An example would be not using equipment properly such as the hoist. We do safeguarding training.”

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We found DoLS applications were sent to the local authority as required and renewed when they expired.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risk assessments were not consistently in place. People had risk assessments in their care plans which covered areas including falls, skin integrity and moving and handling. However, some people who were at risk of choking, did not have risk assessments in place to demonstrate how any risks would be mitigated. The provider implemented these immediately following our feedback

Where people were at risk of skin break down and needed support with re-positioning or had specialist equipment in place such as an airflow mattress, this information was not clearly recorded in people’s care plans. This meant staff did not have all the required information about people’s care. Whilst some of this information was recorded elsewhere within people’s records, we spoke with the provider about ensuring this was also reflected within people’s skin integrity information.

We saw other risks being well managed. For example, we saw people being supported to walk around the home using equipment such as walking frames and walking sticks.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

We found the premises and equipment were well maintained, however an up-to-date fire risk assessment was not in place. The provider made arrangements for this to be completed after our assessment.

Personal emergency evacuation plans (PEEP) were completed and provided details about the support people needed to evacuate the home safely.

We looked around the home environment and found it to be safe. Windows were fitted with restrictors to limit opening and prevent people exiting through them. Radiators were fitted with guards to ensure they didn’t become too hot and present the risks of burns/scalds.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staffing rotas were in place and demonstrated how many staff were available to care for people. The feedback we received from people, staff and relatives indicated they felt staffing levels were sufficient. One member of staff said, “We have enough staff and never feel like we are short.” A person living at the home said, “There are enough for me, but some others don’t understand staff have other people to deal with as well as them and they are very busy.”

Staff were recruited safely, with appropriate pre-employment checks carried out before staff started working with the service which included Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

Staff told us they received enough training to support them in their role. A training matrix was used to monitor training compliance. One member of staff said, “We get training every year and do practical training as well for certain areas.”

Staff supervisions took place throughout the year so staff could receive feedback about their performance and an induction programme was in place.

The provider assessed and managed the risk of infection. They detected and controlled therisk of it spreading and shared concerns with appropriate agencies promptly.

The home was clean, equipment was well maintained, and there were no odours or unpleasant smells. The registered manager completed regular IPC audits of the environment and personal protective equipment, and hand-washing facilities were readily available throughout the service.

Staff had completed infection control training, and we saw domestic staff cleaning the home throughout the inspection.

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.

PRN (when required) medicines were administered to people when needed, and accurately documented, however, specific plans were not in place to inform staff about when these may need to be administered and under what circumstances. People’s medication care plans were also extremely brief, despite being on quite complex medicines. Some people’s care plans simply stated, ‘Manages medication no problem,’ with no further details recorded.

Staff had completed medication training and had their competencies assessed. Medicines were stored safely in a locked trolley which was secured to the wall. Medicines fridges were maintained at suitable temperatures.

Records showed people had their medicines administered on time as prescribed. This included time sensitive medicines. One relative said to us, “[Person] gets it on a regular basis. [Person] was put on anti-depressants after a bad experience at a previous care home. They informed us about the change, and they let us know if the doctor comes.”