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Inspection carried out on 3 September 2019

During a routine inspection

About the service:

The Spinney provides accommodation and personal care for up to three adults who have a learning disability and/or autism. There was one person living in the home when we inspected.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service:

People were safe and protected from abuse and avoidable harm. There were enough staff to support people. New staff were checked to ensure they were suitable to work in the home. People received their medicines safely and as their doctors had prescribed. The provider responded appropriately to incidents that challenged the service to ensure people were safe.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The staff were trained and skilled to provide people’s care. They understood their responsibilities under the Mental Capacity Act 2005 and people’s rights were respected. 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 supported this practice.

The staff supported people to prepare their own snacks and drinks and to make healthy eating choices. People’s needs were assessed and appropriate services were included in planning and providing their care to ensure they maintained good health.

People were treated with kindness and respect. The staff spoke to and about people in a respectful way. The staff knew the person living in the home well and gave them prompt support if they were anxious. The staff included the person in decisions about their care and asked for their views.

The person living in the home received person-centred care that was planned and provided to meet their needs. They were supported to see their relatives as they wished and engaged in a range of activities they enjoyed. The provider had a procedure for responding to complaints about the service.

The registered manager was very experienced and aware of their responsibilities. He and the staff were committed to providing people with a high-quality service which met their needs and provided good outcomes. The provider had arranged additional support for the staff and management team in response to challenges the service had faced. The provider had informed us of incidents in the home and met their responsibilities under the duty of candour.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with pos

Inspection carried out on 23 January 2017

During a routine inspection

The Spinney is a residential care home which provides accommodation, personal care and support for up to three younger adults with learning disabilities, including Autism Spectrum Disorder. At the time of our inspection there were three people living at the service.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

We found that staff had been recruited safely and were aware of how to safeguard people living at the home from abusive practice. Staffing levels at the home were appropriate to meet people’s needs. There were safe processes in place for the management and administration of medicines. This helped to ensure that people received safe care.

Staff had received appropriate training and had the knowledge and skills to provide people with safe care and to meet their needs. 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 at the service supported this practice. People received appropriate support with eating and drinking and their healthcare needs were met at the home.

People living at the home were encouraged and supported by staff to develop their life skills and be as independent as they could be. Visual aids and information provided in a pictorial, easy read format were used to help people to make choices and to support effective communication. We observed staff at the home communicating with people in a kind and caring way. Conversations were often affectionate and playful and we observed people smiling and laughing throughout our inspection.

Staff knew the people they supported well. We saw evidence that people received individualised care that reflected their needs and preferences. People were supported by staff to access a wide variety of activities and they went out into the community regularly.

Feedback had been sought from relatives who expressed a high level of satisfaction with all areas of the service. Relatives and staff were happy with the management of the service. At our previous inspection on 11 August 2014, we found a breach of our regulations relating to a lack of effective systems in place to monitor the quality of the service delivery. At this inspection we found that audits and checks of the service were completed regularly and were effective in ensuring that appropriate levels of quality and safety were maintained.

Further information is in the detailed findings below.

Inspection carried out on 11 August 2014

During a routine inspection

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 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

The inspection was unannounced. The last inspection was carried out on 17 December 2013. All areas reviewed met current standards.

The Spinney provides accommodation and personal care for up to three people with learning disabilities, particularly Autism Spectrum Disorder. At the time of the inspection three people were accommodated in the home. The home is a detached property with a garden at the rear of the property. The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

A person spoken with told us they felt well cared for and safe at The Spinney. We saw that staff treated people with respect and were mindful of their rights to privacy and dignity. All relatives spoken with were complimentary about the service. One relative said, “It’s like winning the lottery finding The Spinney – it’s that good”. Another relative commented, “It’s fantastic, I can’t praise it high enough. My son is very happy and settled”.

The home had appropriate policies and procedures in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. The registered manager understood when an application needed to be made to the local authority and confirmed that staff were using no form of restraint at the time of the inspection.

Each person had an individual care plan which included risk assessments. These told the staff about the risks for each person and how to manage and minimise the risks to help keep people safe. The plans and risk assessments were reviewed at regular intervals to make sure staff had up to date information about people’s needs. People were supported to pursue a variety of activities both inside and outside the home in line with their preferences and interests. Staff working at The Spinney understood people’s needs and we saw care was delivered with kindness and sensitivity.

Staff were appropriately trained and all new staff received a thorough induction, which included shadowing experienced staff. Staff were fully aware of their roles and responsibilities and we found all staff to be well motivated.

There was a lack of effective systems in place to assess and monitor the quality of the service. We found there had been no overall checks of the service by a representative of the provider for several months and there was no programme of audits or development plan. This is a breach of Regulation 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

Inspection carried out on 17 December 2013

During a routine inspection

Families and/or carers who acted for people using services expressed their wishes on their behalf and were involved appropriately in decisions related to their care, treatment and support. We found the provider ensured safe and appropriate care was provided because they planned and delivered support that met the needs of people using services. We found that people were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage all medicines.

There were effective recruitment and selection processes in place because appropriate checks were undertaken before staff began work. Consequently people received care and treatment from suitably qualified and skilled staff. There was a complaints procedure in place at The Spinney that aimed to consider fully, respond appropriately and, when possible, respond within an acceptable time-scale.