Spion Kop Care Home

Spion Kop is a residential care home providing accommodation and personal care to a maximum of six people who have mental health needs. Six people lived at Spion Kop at the time of the inspection. Accommodation was provided in one adapted building. Three bedrooms were ensuite, shared communal facilities included the lounge, dining room, kitchen and bathroom.

There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

People’s experience of using this service and what we found

People received safe care and treatment. There were effective systems in place to assess, monitor and record risk associated with people’s individual needs and staff encouraged people to lead independent lives. The environment was safe, clean and well maintained. Medicines were managed in a safe and person-centred way. Staff demonstrated good understanding of safeguarding people from abuse and avoidable harm.

People had access to a wide range of health care professionals. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not consistently support this practice however, during the inspection the registered manager evidenced how they intended to improve the way people’s mental capacity was assessed.

Staff understood the importance of mental health recovery and people were supported to develop life skills including shopping, cooking and housework. Staff received training and support. People’s end of life preferences and decisions were discussed and recorded.

People told us staff were kind and respectful. Staff engaged with people in a caring way and had built trusting relationships. People were encouraged to be involved in decisions about the way the service was led. Monthly house meetings were held and minuted.

People were involved in the development of their care plans. Staff told us they were trained and supported to understand the importance of mental health recovery and knew how to encourage people to access the local community, engage in work projects and education.

Staff told us the registered manager was supportive and approachable. There was an open and transparent culture. The registered manager understood people’s needs and preferences. There were effective quality assurance processes which showed the manager was aware of their role and responsibilities. People had access to the complaints procedure and told us they felt confident to raise any concerns.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 24/01/2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

There is a requirement for Spion Kop to have a registered manager and a registered manager was in place. 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 service is registered to provide residential care for up to six people with mental health needs. At the time of our inspection six people were using the service.

People were supported to manage their own medicines when this was their choice. Where staff administered medicines for people, medicines were stored safely and records were clearly completed and any support provided respected people’s privacy. One bottle of medicine had an illegible prescription label and one liquid medicine had exceeded the recommended ‘use by’ date. The deputy manager told us action would be taken to resolve these issues. Other medicines were labelled clearly and were in date.

Risks to people’s health were identified and well managed, however one person’s care plan and risk assessment did not contain sufficient detail on the observations staff completed regarding potential risks. Other risks to people, such as from the risk of a potential fire had been considered and plans were in place to reduce risks to people.

People felt safe at the service. Staff had been trained in safeguarding and had the knowledge to identify any potential signs of abuse and how to report those. Staff recruitment practices were followed to ensure people were safe to work at the service. Sufficient numbers of staff were available to meet people’s needs and to support people to attend appointments and activities.

The registered manager understood the principles of the Mental Capacity Act (MCA) 2005 and had a policy in place for both the MCA and Deprivation of Liberty Safeguards (DoLS). No applications for a DoLS had been required as no one lacked the mental capacity to make decisions. However there was not a process to record mental capacity assessments and record any best interests’ decision making, should a person lack the mental capacity to make a decision in the future. We brought this to the attention of the registered manager who agreed to put this in place, should this be required. People’s consent was obtained prior to staff providing any care and support.

People were involved in planning and choosing healthy, nutritious food and drink, as such people made choices that suited their own preferences. People were supported to be involved in meal and drink preparation to promote their independence. People were supported to access any other healthcare services they needed in order to maintain good health.

Staff listened to people and spent time talking with them. People described staff as kind and caring. Staff supported people with their dignity and promoted their independence. People’s views were used to identify improvement in the service and people were involved in planning their own care.

People received personalised and responsive care as they were involved in identifying what support they required. People had been asked about their preferences and staff were aware of these. People contributed to their care planning and were asked for any suggestions, comments or complaints at regular meetings.

The registered manager was clear on their role and responsibilities and was supported by motivated staff team. Staff understood their roles and responsibilities. Systems were in place to check on the quality and safety of services provided.

People told us they were happy with the care and service they received, and felt that their needs were being met. Comments received from people included 'the service is fantastic; the staff have helped me to get my life back on track, we are supported to go on holiday and go out regularly for meals and we all get on well; the staff are very good.'

People also said that they were satisfied with the choice of foods and meals provided, and that they received enough to eat and drink. A planned menu system has been put in place, to ensure that people receive a variety of foods.

People were involved in completing their care records. Care records we looked at showed that people's care and treatment was delivered in a way that ensured their safety and welfare.

The service was flexible and centred around individual needs and preferences. We found that the service was well managed, and that clear lines of responsibility were in place. This meant that people received consistent standards of care and service.

People said they liked the staff that supported them as they were honest and reliable, and they understood their needs. The provider's recruitment procedures have been strengthened to ensure that people are cared for by suitably trained, skilled and experienced staff.