Archived: Spring View

Updated 1 March 2017

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.

This inspection took place on 11 January 2017 and was announced. We gave the service 24 hours’ notice because it is a small care home and we wanted to be certain people would be in. We also wanted to be certain the registered manager would be available when we visited. The inspection was carried out by one adult social care inspector.

Before the inspection we reviewed the information we held about the service. This included previous inspection reports, statutory notifications (issues providers are legally required to notify us about), other enquiries received from or about the service and the Provider’s Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and the improvements they plan to make. The service was previously inspected on 1 and 4 December 2015 when we found breaches of Regulation 12; Safe care and treatment, and Regulation 17; Good governance.

We met each of the six people living there. They had complex learning disabilities and not all were able to tell us about their experiences of life at the home. We therefore used our observations of care and our discussions with staff to help form our judgements. We spoke with the registered manager and four members of staff. We looked at the premises and throughout the day we observed care practices in communal areas. We looked at a number of records relating to individual care and the running of the home. These included three care and support plans, medication records, menus, two staff personal files, staff rotas, training records and records related to quality monitoring. After the inspection we spoke with three relatives on the telephone.

Updated 1 March 2017

This inspection took place on 11 January 2017 and was announced. We gave the service 24 hours’ notice because it is a small care home and people may have been out. We also wanted to be certain the registered manager would be available when we visited.

The service was previously inspected on 1 and 4 December 2015 when we found breaches of Regulation 12; Safe care and treatment, and Regulation 17; Good governance. At this inspection we found actions had been taken to address the issues found at the last inspection.

Spring view is one of a number of services operated by this provider. The home provides care and support to up to six people with profound and multiple learning disabilities. It is has five bedrooms in the main part of the house and one bedroom in an attached, but self-contained, flat. The home has been adapted to meet the needs of the people who currently live there. It is situated in a quiet residential area of Yeovil. At the time of this inspection there were six people living there.

The people we met had complex learning disabilities and not all were able to tell us about their experiences of life at the home. We therefore used our observations of care and our discussions with staff to help form our judgements.

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.

At the last inspection we found three breaches of our regulations. These related to safe care and treatment and lack of adequate governance systems. Risks to people at night had not been fully considered, care and support plans had not been regularly reviewed, and systems to monitor the quality of the service were not fully effective. At this inspection we found that risk assessments had been put in place to ensure that staff working alone at night were able to hear if people required assistance, and knew how to request management advice and support, or additional staff if necessary. We also found that care plans and risk assessments had been reviewed and updated. Quality monitoring systems were in place to ensure most aspects of the service were regularly checked and actions carried out where improvements were needed. However, we found one new breach of regulation relating to the storage of controlled drugs.

People’s medicines were not always stored securely. Each person had secure storage facilities in their rooms for their medicines. The medicine cabinets were suitable for most medicines, but did not provide adequate security for those medicines classified as controlled drugs. We have made a recommendation that the provider seeks advice from a reputable source on suitable storage facilities for controlled drugs to comply with their legal obligations. Staff had received training on the safe administration of medicines and records showed staff had administered and recorded all medicines appropriately, and in line with the prescriber’s instructions.

Risk assessments were completed and staff had access to information on how to support people to remain safe. However, the way the information was presented may mean that staff did not always read the full information and may not follow the advice safely, for example foods that people with swallowing difficulties may eat safely. The registered manager told us they would take immediate action to address this. A member of staff told us a training session on eating and drinking was planned for the following day.

People were protected from the risk of harm as staff had been trained to recognise and report abuse. Safe recruitment procedures were followed before new staff began working with people. All staff completed a thorough induction at the start of their employment to ensure they had the skills needed to meet people’s needs effectively.

The service respected people’s human rights and diversity and promoted people’s rights to make choices and decisions about their lives where possible. Staff had received training on the Mental Capacity Act 2005. Capacity assessments had been carried out where appropriate and best interest decisions had been made where necessary through discussion and agreement with relatives and professionals who knew people well.

People were supported by kind and caring staff. People who were unable to verbally express themselves appeared relaxed and comfortable with staff. We asked one person if they were happy living at the home and they replied “Yes” with a very big smile. Staff were attentive, calm and gentle in all interactions with people. We asked three relatives if they felt staff were caring. One replied, “Oh yes, definitely.” The second relative said “We feel very fortunate that (person’s name) was given a placement there. We are reassured that he is happy where he is.” Another relative said, “We are very happy with the care. They are very understanding”.

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We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.