CQC report explained · a residential care home
What the CQC found at The Spinney Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Medicines were not always managed safely. Inspectors also found infection control and environmental safety shortfalls, although people's care risks were assessed and staff understood safeguarding duties.
- Effective?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was used in calculating the overall rating.
- Well-led?
- Requires improvement
- Some management audits and checks failed to identify medicine and environmental problems. Staff felt supported, and the manager acted quickly on issues raised during the inspection.
What inspectors found, March 2022
Rated Requires Improvement; inspectors found unsafe medicines management and infection control shortfalls, although risks to people's care were generally assessed well.
The CQC made two unannounced visits, on 18 January and 8 February 2022. The inspection began after concerns about infection prevention and control. It was then widened to look at Safe and Well-led only.
Inspectors found medicines were not always managed safely. Creams were stored unlocked in bedrooms, and five medicine discrepancies were found. They also found gaps in infection checks, cleaning records, PPE arrangements and some environmental safety checks.
People and relatives said they were happy with the care and felt safe. Staff were available and understood safeguarding duties. By the second visit, the manager had addressed the infection control issues identified at the first visit.
The overall rating fell from Good at the previous inspection, published in January 2018, to Requires Improvement. The Effective, Caring and Responsive areas were not inspected during this visit, so their previous ratings were used.
Care risks were assessed
Inspectors found that risks linked to people's care were assessed, reviewed and explained in care plans for staff.
“Risks associated with people's care had been assessed and regularly reviewed.” from the report
People felt safe
People and relatives said they felt safe and were happy with the care. Staff were available and responded promptly to requests for help.
“People felt safe living at The Spinney Care Home and staff understood their responsibility to keep people safe.” from the report
Action was taken
The manager acted during the inspection to address the medicine, fire safety and infection control issues. The second visit found that the infection control issues raised earlier had been addressed.
“During the second inspection on 08 February 2022 we found the manager had addressed all the areas we raised regarding infection prevention and control.” from the report
Friendly atmosphere
Inspectors found the home friendly and inclusive. People, staff and the manager interacted in a relaxed and familiar way.
“The atmosphere in the home was friendly and inclusive.” from the report
Medicines were not always safe
seriousPrescribed creams were left unlocked in bedrooms. Inspectors also found five discrepancies in the medicines stored, creating a risk that medicines might not be given correctly.
“There were five discrepancies identified in the number of medications stored in the home, at the time of the inspection.” from the report
Infection control checks were incomplete
seriousThere were gaps in visitor screening and records for vaccination checks, tests and cleaning. Some areas appeared unclean, and the home was not fully following the latest infection control guidance at the time.
“We were not assured that the provider was promoting safety through the layout and hygiene practices of the premises.” from the report
Management checks missed problems
needs fixingSome audits were not effective enough to identify the medicine and environmental issues found by inspectors.
“We found the manager's checks on the environment and medication had failed to identify the issues we found.” from the report
Fire safety issue
seriousSome bedroom doors were propped open during the second visit, creating a fire risk. The manager dealt with this immediately.
“During day two of our inspection, some bedroom doors were propped open which was a fire risk.” from the report
- 01How are medicine stocks and discrepancies checked now, and how are prescribed creams kept secure?
- 02How do you record visitor vaccination checks, lateral flow tests and COVID-19 screening?
- 03How often are cleaning records, infection control audits and PPE competency checks reviewed?
- 04What checks now make sure bedroom doors are not propped open and other fire risks are found?
- 05What progress has been made against the action plan since the February 2022 inspection?
This was a focused inspection of Safe and Well-led after infection control concerns; Effective, Caring and Responsive were not inspected and their previous ratings carried over. This explanation was written from the published report of 30 March 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, January 2018
Rated Good; inspectors found safe, kind and personalised care, with some records and information still needing attention.
Inspectors visited the home without warning on 7 December 2017. They spoke with four people living there, the registered manager and four care staff. They observed care and checked care records, medicines, recruitment, complaints and quality checks.
The home was rated Good overall, with Good ratings for Safe, Effective, Caring, Responsive and Well-led. People told inspectors they felt safe, respected and listened to. Inspectors found enough staff, safe medicines practice, suitable training and support from health professionals.
The home had improved since October 2016, when it was rated Requires Improvement. Medicines management, care planning, activities and quality checks had improved. However, some care plan reviews were not clearly recorded, and the home had not yet considered accessible information in detail.
Improved medicines safety
The home had introduced an electronic medicines recording system after earlier problems. Inspectors found medicines were given on time and as prescribed.
“These records showed people received their medicines as prescribed, as staff accurately recorded what had been given and when.” from the report
Kind and respectful care
People said staff were kind and respectful. Inspectors observed staff supporting people's comfort, dignity and choices.
“People told us staff treated them with kindness, dignity and respect.” from the report
Personalised support
Care plans included people's likes, dislikes and desired outcomes. Staff supported hobbies, activities and interests, including one-to-one activities.
“Care plans were detailed and described the outcomes people wanted to achieve, and the steps people wanted to take to achieve them.” from the report
Enough trained staff
People and staff told inspectors there were enough staff, including at night. Staff received induction, training, supervision and competence checks.
“We saw there were adequate numbers of staff available at all times to care for people safely, and meet people's care needs promptly.” from the report
Better management checks
The provider had improved its audits and used feedback and action plans to make changes. Staff said the manager was approachable and listened to concerns.
“A range of audits were completed such as infection control, health and safety, care plans and medicines audits to help the service improve.” from the report
Care plan reviews not always recorded
needs fixingInspectors found that reviews were taking place but were not always documented clearly. The manager agreed to record who had been involved and how their views affected care.
“However, reviews were not always documented in people's care plans.” from the report
Accessible information had not been considered fully
minorThe home had not yet considered in detail how to provide information for people with disabilities, impairments or sensory loss. The manager said this would be addressed over the following months.
“They acknowledged this was not something they had yet considered in detail at The Spinney” from the report
- 01How are care plan reviews recorded now, including who took part and what changed as a result?
- 02What action has been taken to meet the Accessible Information Standard since this inspection?
- 03Is the electronic medicines recording system still being used, and how are staff's medicines competencies checked?
- 04How are activities matched to each person's interests, including people who prefer one-to-one support?
- 05How do you check current staffing levels, including at night, against people's changing needs?
This was an unannounced inspection of the overall service, covering all five CQC questions: Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 19 January 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of The Spinney Care Home
4 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- March 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2018Goodup from Requires improvementSafe: GoodWell-led: Good
- January 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 14 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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