Archived: The Spinney

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 positive behaviour support principles.

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 3 March 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.

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.

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.